Fardella C E, Montero J, Mosso L
Departamentos de Endocrinología y Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile.
Rev Med Chil. 1999 May;127(5):604-10.
Recently, some genetic forms of hypertension have been well characterized. These forms can be globally called mineralocorticoid hypertension and are due to different alterations of the renin-angiotensin-aldosterone system (SRAA). Among these, classic primary hyperaldosteronism and its glucocorticoid remediable variety, in which hypertension is secondary to aldosterone production, must be considered. There are also conditions in which mineralocorticoid activity does not depend on aldosterone production. These conditions generate a hyporeninemic hyperaldosteronism, observed in Liddle syndrome, apparent mineralocorticoid hypertension, 11- and 17-hydroxylase deficiency, among others. The detection of these forms of hypertension is only feasible if the renin-angiotensin-aldosterone system is assessed, measuring renin and aldosterone levels. This article reviews these forms of hypertension, their clinical workup and their relevance in the usual hypertensive patients.
最近,一些遗传性高血压类型已得到充分表征。这些类型可统称为盐皮质激素性高血压,是由肾素-血管紧张素-醛固酮系统(RAAS)的不同改变所致。其中,必须考虑经典原发性醛固酮增多症及其糖皮质激素可治性类型,在这些类型中高血压继发于醛固酮分泌。也有一些情况,盐皮质激素活性并不依赖于醛固酮分泌。这些情况会导致低肾素性醛固酮增多症,见于利德尔综合征、表观盐皮质激素性高血压、11-β-羟化酶缺乏症和17-α-羟化酶缺乏症等。只有评估肾素-血管紧张素-醛固酮系统,测量肾素和醛固酮水平,才能检测出这些类型的高血压。本文综述了这些类型的高血压、其临床检查以及它们在普通高血压患者中的相关性。