LICORICE-INDUCED HYPERTENSION - A NEW UNDERSTANDING OF AN OLD DISEASE- CASE-REPORT AND BRIEF REVIEW

The case is described of a 40-year-old female with severe hypertension and hypokalaemic metabolic alkalosis, due to prolonged liquorice inge stion. The pseudo-aldosterone-like effects of liquorice have always be en attributed to glycyrrhizic acid, but its biochemical substrate has remained elusive. It is now known that glycyrrhetenic acid, the hydrol ytic metabolite of glycerrhizic acid, is the active component of liquo rice which causes inhibition of the peripheral metabolism of cortisol. Cortisol binds with the same affinity as aldosterone to the mineraloc orticoid receptor resulting in a hypermineralocorticoid condition. Ing estion of liquorice may therefore result in retention of sodium and wa ter, hypertension, hypokalaemia, alkalosis and suppression of the reni n-aldosterone system. The literature on liquorice-induced hypertension is briefly reviewed with emphasis on the biochemical features of this mineralocorticoid excess syndrome.