By Christian A Koch, George P Chrousos
The superiority of high blood pressure is sort of 3 times as excessive as that of diabetes mellitus style 2, with either stipulations being significant danger components for stroke, ischemic middle sickness, cardiac arrhythmias, and middle failure. the precise incidence of high blood pressure relating to hormonal derangements (endocrine high blood pressure) isn't identified yet envisioned to impact below 15% of hypertensive patients. fresh clinical discoveries have elevated the knowledge of the pathophysiologic mechanisms of hypertension. In Endocrine high blood pressure, a well known panel of specialists presents a accomplished, state of the art evaluate of this disease, discussing while to assign an endocrine reason in a single of many stipulations which can current with hypertension. the 1st a part of Endocrine high blood pressure is devoted to adrenal causes. the second one a part of the amount matters strength nonadrenal motives of high blood pressure, akin to development hormone extra or deficiency, fundamental hyperparathyroidism, diet D deficiency, testosterone deficiency, insulin resistance, obesity-associated high blood pressure, and the position of imperative mineralocorticoid receptors and heart problems. a big contribution to the literature, Endocrine high blood pressure is an essential reference not just for endocrinologists, diabetologists, and adrenal investigators, but in addition for translational scientists and clinicians from cardiology, inner medication, pediatrics, relations drugs, geriatrics, urology, and reproductive medication / gynecology.
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22 P. Mulatero et al. Familial Forms of Primary Aldosteronism Three forms of familial hyperaldosteronism have been described to date referred to as FH-I, FH-II, and FH-III. FH-I, also known as GRA, is a monogenic form transmitted as an autosomal-dominant disease and responsible for fewer than 1% of PA. FH-I is due to an unequal recombination between CYP11B1 and CYP11B2 . GRA is transmitted as an autosomal-dominant disease. Its main clinical features are elevated ACTH-dependent aldosterone secretion, renin suppression, and high levels of the hybrid steroids 18-hydroxycortisol and 18-oxocortisol .
Spironolactone versus eplerenone for the treatment of idiopathic hyperaldosteronism. Expert Opin Pharmacother. 2008;9:509–15. Chapter 2 Syndromes of Mineralocorticoid Excess Eugen Melcescu and Christian A. Koch Abstract In addition to obesity, diabetes type 2, and the metabolic syndrome, hypertension represents a major public and global health problem, most of which can be improved by lifestyle changes, including changing dietary habits with less consumption of processed and preserved foods, which generally contain higher amounts of salt than freshly prepared food items.
Aldosterone mediates its action through the mineralocortoid receptor (MR) which regulates salt homeostasis in the kidneys and plays a range of other roles in the vasculature, heart, brain, and adipose tissue. To mediate transcription of target genes, the MR interacts with both mineralocorticoids and glucocorticoids (reviewed in ). The MR is able to exert tissue- and ligandspecific effects via its interactions with a range of binding partners. The MR also plays a major role in inducing glomerular podocyte injury and progression of chronic kidney disease which can be reduced by MR antagonists or selective MR inhibition .