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Int. J. Mol. Sci. 2018, 19(2), 546;

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

Department of Endocrinology, Endocrine Hypertension and Adrenal Disease Program, School of Medicine, Pontificia Universidad Catolica De Chile, Santiago 8330074, Chile
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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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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