Examinando por Autor "Baudrand, Rene"

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    Classic and “non-classic” apparent mineralocorticoid excess
    (Elsevier, 2025) Baudrand, Rene; Carvajal, Cristian; Tapia-Castillo, Alejandra; Uslar, Thomas; Fardella, Carlos
    Hypertension is highly prevalent in the general population. Up to 1/3 of patients display low-renin levels due to aldosterone-mediated mineralocorticoid receptor (MR) activation or cortisol-mediated MR activation. The spectrum of cortisol-mediated MR activation includes the classic apparent mineralocorticoid excess (AME), Cushing syndrome or milder (non-classic) forms of AME, the latter with a much higher prevalence and subtle phenotype. Classic AME is a rare autosomal recessive disorder caused by the presence of a severe dominant autosomal deficiency of 11bHSD2 gene. Non-classic -AME (NC-AME) is mainly associated with partial 11bHSD2 deficiency due to milder genetic variations or epigenetic modifications plus potential actions of endogenous or exogenous inhibitors. Treatment aims to ameliorate MR activation with low-sodium diet and MR antagonists.
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    Driving hypertension: non-classic apparent mineralocorticoid excess
    (Springer Nature, 2025-11-12) Carvajal, Cristian A.; Tapia-Castillo, Alejandra; Uslar, Thomas; Vaidya, Anand; Pérez, Jorge A.; Baudrand, Rene; Fardella, Carlos E.
    Non-classic apparent mineralocorticoid excess is an underrecognized cause of low-renin hypertension, which is often misdiagnosed as essential hypertension. This condition challenges traditional classifications and highlights the need for mechanism-based diagnostics and medical care. Hypertension remains a leading contributor to global cardiovascular morbidity and mortality. It has a high prevalence, low rate of identifiable causes and is frequently resistant to conventional therapy. Hypertension is traditionally classified as ‘essential’ and multifactorial; however, up to one-third of patients have hypertension with a low-renin phenotype . This subtype has been largely attributed to primary aldosteronism, yet emerging data suggest a broader and more complex spectrum of mineralocorticoid receptor (MR) overactivation. Non-classic apparent mineralocorticoid excess (NC-AME) is one of several overlooked contributors to low-renin hypertension; NC-AME might account for a meaningful proportion of patients who have been misclassified as having essential hypertension.