Результаты исследований: Научные публикации в периодических изданиях › обзорная статья › Рецензирование
Genetics and pathophysiology of low-renin arterial hypertension. / Markel, A. L.
в: Вавиловский журнал генетики и селекции, Том 22, № 8, 01.01.2018, стр. 1000-1008.Результаты исследований: Научные публикации в периодических изданиях › обзорная статья › Рецензирование
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TY - JOUR
T1 - Genetics and pathophysiology of low-renin arterial hypertension
AU - Markel, A. L.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - The review is devoted to the consideration of genetic determination and pathophysiology of one of the forms of hypertensive disease known as low-renin hypertension. At first glance, the development of low-renin hypertension is “unnatural”, as renin, as a key enzyme of the renin-angiotensin system, which plays an important role in the development of hypertensive disease, is suppressed in low-renin hypertension. At the same time, the most important drugs actual in the treatment of hypertensive disease belong to the renin-angiotensin system blockers. This contradiction was resolved by a study of genetic and pathophysio-logical mechanisms of hypertension in some groups of patients with characteristic symptoms bringing these people together. Genetic studies of some recent decades using both family analysis and modern molecular genetic technologies have revealed the main mechanisms underlying low-renin hypertension, which can be classified as certain syndromes with well-defined genetic and clinical features. These syndromes include cases of sporadically occurring somatic mutations in the cells of the adrenal cortex, which begin to produce aldosterone in increased amounts. Also, several oligogenic forms of low-renin hypertension were studied, some of which are associated with the hyperproduction of aldosterone, but in the others the development of low-renin hypertension was associated with mutations of genes involved in regulation of the functioning of the kidney ion channels. The discovery of some types of arterial hypertension with known mechanisms of their development is of paramount importance for medicine, as it allows for targeted efective therapy and in some cases for achieving a complete cure. However, the main contingent of patients with low-renin hypertension belongs to cases with unexplained etiology, as their development is associated with polygenic systems and with a significant influence of numerous environmental factors. The study of genetic and physiological mechanisms of various forms of low-renin arterial hypertension provides a good example of how penetration into the intimate mechanisms of the blood pressure regulation in each personal case makes it possible to identify some specific syndromes and establish its final causes. It seems that progress in understanding the causes and mechanisms of essential hypertension lies along this way.
AB - The review is devoted to the consideration of genetic determination and pathophysiology of one of the forms of hypertensive disease known as low-renin hypertension. At first glance, the development of low-renin hypertension is “unnatural”, as renin, as a key enzyme of the renin-angiotensin system, which plays an important role in the development of hypertensive disease, is suppressed in low-renin hypertension. At the same time, the most important drugs actual in the treatment of hypertensive disease belong to the renin-angiotensin system blockers. This contradiction was resolved by a study of genetic and pathophysio-logical mechanisms of hypertension in some groups of patients with characteristic symptoms bringing these people together. Genetic studies of some recent decades using both family analysis and modern molecular genetic technologies have revealed the main mechanisms underlying low-renin hypertension, which can be classified as certain syndromes with well-defined genetic and clinical features. These syndromes include cases of sporadically occurring somatic mutations in the cells of the adrenal cortex, which begin to produce aldosterone in increased amounts. Also, several oligogenic forms of low-renin hypertension were studied, some of which are associated with the hyperproduction of aldosterone, but in the others the development of low-renin hypertension was associated with mutations of genes involved in regulation of the functioning of the kidney ion channels. The discovery of some types of arterial hypertension with known mechanisms of their development is of paramount importance for medicine, as it allows for targeted efective therapy and in some cases for achieving a complete cure. However, the main contingent of patients with low-renin hypertension belongs to cases with unexplained etiology, as their development is associated with polygenic systems and with a significant influence of numerous environmental factors. The study of genetic and physiological mechanisms of various forms of low-renin arterial hypertension provides a good example of how penetration into the intimate mechanisms of the blood pressure regulation in each personal case makes it possible to identify some specific syndromes and establish its final causes. It seems that progress in understanding the causes and mechanisms of essential hypertension lies along this way.
KW - Aldosterone
KW - Arterial blood pressure
KW - Genetic determination
KW - Hypertensive disease
KW - Kidney ion channels
KW - Low-renin hypertension
KW - Pathophysiology
KW - Regulation
KW - Renin
KW - arterial blood pressure
KW - regulation
KW - hypertensive disease
KW - low-renin hypertension
KW - genetic determination
KW - pathophysiology
KW - aldosterone
KW - renin
KW - kidney ion channels
KW - ALDOSTERONE-PRODUCING ADENOMAS
KW - SALT SENSITIVITY
KW - BLOOD-PRESSURE
KW - MINERALOCORTICOID RECEPTOR
KW - CONFIRMATORY TESTS
KW - SOMATIC MUTATIONS
KW - CHANNEL MUTATIONS
KW - DIAGNOSIS
KW - SECRETION
KW - PREVALENCE
UR - http://www.scopus.com/inward/record.url?scp=85064809509&partnerID=8YFLogxK
UR - https://www.elibrary.ru/item.asp?id=36587801
U2 - 10.18699/VJ18.443
DO - 10.18699/VJ18.443
M3 - Review article
AN - SCOPUS:85064809509
VL - 22
SP - 1000
EP - 1008
JO - Вавиловский журнал генетики и селекции
JF - Вавиловский журнал генетики и селекции
SN - 2500-0462
IS - 8
ER -
ID: 19647279