Mineralocorticoid and apparent mineralocorticoid syndromes of secondary hypertension

Adv Chronic Kidney Dis. 2015 May;22(3):185-95. doi: 10.1053/j.ackd.2015.03.002.

Abstract

The mineralocorticoid aldosterone is a key hormone in the regulation of plasma volume and blood pressure in man. Excessive levels of this mineralocorticoid have been shown to mediate metabolic disorders and end-organ damage more than what can be attributed to its effects on blood pressure alone. Inappropriate excess levels of aldosterone contribute significantly to the cardiorenal metabolic syndrome and target organ injury that include atherosclerosis, myocardial hypertrophy, fibrosis, heart failure, and kidney disease. The importance of understanding the role of excess mineralocorticoid hormones such as aldosterone in resistant hypertension and in those with secondary hypertension should be visited. Primary aldosteronism is one of the commonly identified causes of hypertension and is treatable and/or potentially curable. We intend to review the management of mineralocorticoid-induced hypertension in the adult population along with other disease entities that mimic primary aldosteronism.

Keywords: Aldosteronism; Apparent mineralocorticoid excess; Resistant hypertension; Secondary hypertension.

Publication types

  • Review

MeSH terms

  • Adrenal Cortex Neoplasms / complications
  • Adrenal Cortex Neoplasms / metabolism
  • Adrenal Cortex Neoplasms / surgery*
  • Adrenal Hyperplasia, Congenital / complications
  • Adrenal Hyperplasia, Congenital / drug therapy*
  • Adrenocortical Adenoma / complications
  • Adrenocortical Adenoma / metabolism
  • Adrenocortical Adenoma / surgery*
  • Aldosterone / blood
  • Aldosterone / metabolism
  • Drug Resistance
  • Humans
  • Hyperaldosteronism / complications
  • Hyperaldosteronism / therapy*
  • Hypertension / etiology
  • Hypertension / therapy*
  • Mineralocorticoid Receptor Antagonists / therapeutic use*

Substances

  • Mineralocorticoid Receptor Antagonists
  • Aldosterone