Hypertension and mineralocorticoids. Usefulness of renin and aldosterone measurements

Recently, some genetic forms of hypertension have been well characterized. These forms can be globally called mineralocorticoid hypertension and are d ue to different alterations of the renin-angiotensin-aldosterone system (SR AA). Among these, classic primary hyperaldosteronism and its glucocorticoid remediable variety, in which hypertension is secondary to aldosterone prod uction, must be considered. There are also conditions in which mineralocort icoid activity does not depend on aldosterone production. These conditions generate a hyporeninemic hyperaldosteronism, observed in Liddle syndrome, a pparent mineralocorticoid hypertension, 11- and 17-hydroxilase deficiency, among others. The detection of these forms of hypertension is only feasible if the renin-angiotensin-aldosterone system is assessed, measuring renin a nd aldosterone levels. This article reviews these forms of hypertension, th eir clinical workup and their relevance in the usual hypertensive patients.