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Int. J. Mol. Sci. 2018, 19(2), 546; https://doi.org/10.3390/ijms19020546

The Low-Renin Hypertension Phenotype: Genetics and the Role of the Mineralocorticoid Receptor

1
Department of Endocrinology, Endocrine Hypertension and Adrenal Disease Program, School of Medicine, Pontificia Universidad Catolica De Chile, Santiago 8330074, Chile
2
Department of Medicine, Division of Endocrinology Diabetes and Hypertension, Center for Adrenal Disorders, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
*
Author to whom correspondence should be addressed.
Received: 19 January 2018 / Revised: 31 January 2018 / Accepted: 8 February 2018 / Published: 11 February 2018
(This article belongs to the Special Issue Role of Genomics in the Management of Hypertension)
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Abstract

A substantial proportion of patients with hypertension have a low or suppressed renin. This phenotype of low-renin hypertension (LRH) may be the manifestation of inherited genetic syndromes, acquired somatic mutations, or environmental exposures. Activation of the mineralocorticoid receptor is a common final mechanism for the development of LRH. Classically, the individual causes of LRH have been considered to be rare diseases; however, recent advances suggest that there are milder and “non-classical” variants of many LRH-inducing conditions. In this regard, our understanding of the underlying genetics and mechanisms accounting for LRH, and therefore, potentially the pathogenesis of a large subset of essential hypertension, is evolving. This review will discuss the potential causes of LRH, with a focus on implicated genetic mechanisms, the expanding recognition of non-classical variants of conditions that induce LRH, and the role of the mineralocorticoid receptor in determining this phenotype. View Full-Text
Keywords: renin; low-renin; hypertension; mineralocorticoid receptor; genetics; aldosterone renin; low-renin; hypertension; mineralocorticoid receptor; genetics; aldosterone
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Baudrand, R.; Vaidya, A. The Low-Renin Hypertension Phenotype: Genetics and the Role of the Mineralocorticoid Receptor. Int. J. Mol. Sci. 2018, 19, 546.

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