Actualización en el manejo clínico de la hipertensión hiporreninémica

Autores/as

  • Stefano Macchiavello
  • Carlos Fardella
  • René Baudrand

Palabras clave:

Aldosterone, Hypertension, Receptors, Mineralocorticoids, Renin, Spironolactone

Resumen

The renin-angiotensin-aldosterone system modulates volume, sodium and potassium homeostasis. In the setting of a high sodium diet, up to 30% of patients with hypertension have a low or suppressed renin and increased volume. This phenotype of low renin hypertension (LRH) is multifactorial and includes infrequent inherited genetic syndromes, milder phenotypes of classic diseases and environmental exposures. All these conditions have in common a higher cardiovascular risk mediated by the over activation of the mineralocorticoid receptor (MR), present not only in the kidney, but also in vasculature, myocardium and adipocytes. Consequently, the aim of LRH treatment goes beyond the control of blood pressure and requires antagonizing MR with specific pharmacologic agents, pursuing normalization of renin as a clinical objective. Due to the unusual evaluation of renin status by non-endocrinologists and lack of disease awareness, only a minority of hypertensive patients receive this pathophysiologically-driven treatment that should reduce cardiovascular outcomes.

Biografía del autor/a

Stefano Macchiavello

Residente endocrinología UC

Carlos Fardella

Jefe departamento endocrinología UC

René Baudrand

Profesor Asociado Endocrinología UC

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Publicado

2019-01-30

Cómo citar

Macchiavello, S., Fardella, C., & Baudrand, R. (2019). Actualización en el manejo clínico de la hipertensión hiporreninémica. Revista Médica De Chile, 147(4). Recuperado a partir de https://revistamedicadechile.cl/index.php/rmedica/article/view/7193

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