The role of adrenal steroidogenesis in arterial hypertension

Mohaupt, Markus (2008). The role of adrenal steroidogenesis in arterial hypertension. In: Mullis, Primus E; Flück, Christa E; Miller, Walter L (eds.) Disorders of the Human Adrenal Cortex. Endocrine Development: Vol. 13 (pp. 133-144). Basel: Karger 10.1159/000134830

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Adrenal aldosterone production, the major regulator of salt and water retention, is discussed with respect to hypertensive diseases. Physiological aldosterone production is tightly regulated, either stimulated or inhibited, in the adrenal zona glomerulosa by both circulating factors and/or by locally derived endothelial factors. Arterial hypertension caused by volume overload is the leading clinical symptom indicating increased mineralocorticoid hormones. Excessive aldosterone production is seen in adenomatous disease of the adrenals. The balance between stimulatory/proliferative and antagonistic signaling is disturbed by expression of altered receptor subtypes in the adenomas. Increased aldosterone production without a detectable adenoma is the most frequent form of primary aldosteronism. Both increased sensitivity to agonistic signals and activating polymorphisms within the aldosterone synthase gene (CYP11B2) have been associated with excessive aldosterone production. 17alpha-Hydroxylase deficiency and glucocorticoidremediable aldosteronism can also cause excessive mineralocorticoid synthesis. In contrast, the severe form of pregnancy-induced hypertension, preeclampsia, is characterized by a compromised volume expansion in the presence of inappropriately low aldosterone levels. Initial evidence suggests that compromised CYP11B2 is causative, and that administration of NaCl lowered blood pressure in pregnant patients with low aldosterone availability due to a loss of function.

Item Type:

Book Section (Book Chapter)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Nephrology and Hypertension

UniBE Contributor:

Mohaupt, Markus

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1421-7082

ISBN:

978-3-8055-8580-4

Series:

Endocrine Development

Publisher:

Karger

Language:

English

Submitter:

Markus Georg Mohaupt

Date Deposited:

04 Oct 2013 15:05

Last Modified:

19 Dec 2014 08:11

Publisher DOI:

10.1159/000134830

PubMed ID:

18493138

BORIS DOI:

10.7892/boris.28104

URI:

https://boris.unibe.ch/id/eprint/28104 (FactScience: 116728)

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