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Actualización en el manejo clínico de la hipertensión hiporreninémica

UPDATE IN THE CLINICAL MANAGEMENT OF LOW RENIN HYPERTENSION

dc.contributorNoes-ES
dc.contributoren-US
dc.creatorMacchiavello, Stefano
dc.creatorFardella, Carlos
dc.creatorBaudrand, René
dc.date2019-01-30
dc.date.accessioned2019-11-11T18:26:58Z
dc.date.available2019-11-11T18:26:58Z
dc.identifierhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/7193
dc.identifier.urihttps://revistaschilenas.uchile.cl/handle/2250/110908
dc.descriptionThe 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.es-ES
dc.descriptionThe 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.en-US
dc.formatapplication/pdf
dc.languagespa
dc.publisherRevista Médica de Chilees-ES
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/view/7193/4870
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38008
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38009
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38010
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38011
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38012
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38378
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38867
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38868
dc.relationhttp://www.revistamedicadechile.cl/ojs/index.php/rmedica/article/downloadSuppFile/7193/38968
dc.sourceRevista Médica de Chile; Vol. 147, núm. 4 (2019): ABRIL 2019es-ES
dc.source0034-9887
dc.subjectAldosterone; Hypertension; Receptors, Mineralocorticoids; Renin; Spironolactonees-ES
dc.subjectAldosterone; Hypertension; Receptors, Mineralocorticoids; Renin; Spironolactoneen-US
dc.titleActualización en el manejo clínico de la hipertensión hiporreninémicaes-ES
dc.titleUPDATE IN THE CLINICAL MANAGEMENT OF LOW RENIN HYPERTENSIONen-US
dc.typeinfo:eu-repo/semantics/article
dc.typeinfo:eu-repo/semantics/publishedVersion
dc.typees-ES


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