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Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
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Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
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In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
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Low-Renin Hypertension.

Shobana Athimulam1, Natalia Lazik2, Irina Bancos1

  • 1Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.

Endocrinology and Metabolism Clinics of North America
|October 28, 2019
PubMed
Summary

Low-renin hypertension, common in 30% of patients, encompasses various conditions. This review details diagnostic approaches for low-renin, low-aldosterone hypertension, including genetic subtypes.

Keywords:
Apparent mineralocorticoid excess syndromeCYP11B1 and CYP17 deficiencyGlucocorticoid-resistance syndromeGordon syndromeLiddle syndromeLow-renin hypertensionMineralocorticoid receptor– activating mutationPrimary aldosteronism

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Area of Science:

  • Nephrology
  • Endocrinology
  • Genetics

Background:

  • Low-renin hypertension impacts a significant portion of hypertensive individuals.
  • Primary hyperaldosteronism is characterized by suppressed renin and elevated aldosterone.
  • Low-renin, low-aldosterone hypertension is a diverse group of disorders.

Purpose of the Study:

  • To review conditions presenting with low-renin hypertension.
  • To outline diagnostic strategies for low-renin hypertension.
  • To highlight genetic factors in familial low-renin hypertension.

Main Methods:

  • Literature review of conditions causing low-renin hypertension.
  • Analysis of diagnostic criteria and approaches.
  • Examination of genetic classifications of familial hypertension.

Main Results:

  • Low-renin hypertension includes essential, hereditary, and secondary forms.
  • Diagnostic workup should differentiate various underlying causes.
  • Genetic subtypes are crucial in understanding familial forms.

Conclusions:

  • A systematic diagnostic approach is essential for managing low-renin hypertension.
  • Understanding the spectrum of low-renin hypertension aids in targeted treatment.
  • Genetic insights are vital for familial hypertension management.