NEW MECHANISMS FOR CORTICOSTEROID-INDUCED HYPERTENSION

A substantial proportion of patients with secondary hypertension have disorders of the adrenal cortex. Not surprisingly, corticosteroids wer e amongst the first putative pathogenic mediators to be investigated i n essential hypertension. Despite this long history, there remains con troversy about the mechanisms which promote abnormal adrenocortical se cretion, the tissues and receptors which mediate corticosteroids' effe cts on blood pressure, and the relevance of corticosteroids in essenti al hypertension. Several recent advances relate to adrenocortical secr etion in hypertension, but arguably the most significant progress has been in understanding factors which control tissue sensitivity to cort icosteroids. It is from this latter perspective that it now seems most likely that the role, if any, of the adrenal cortex in essential hype rtension will become apparent.