Low renin hypertension: cause, treatment, etc.

If RAAS works as expected, high levels of renin raise blood pressure. However, with LRH, you will experience high blood pressure even with low or typical renin levels. You may not have enough renin to help initiate the process of controlling your blood pressure.

The cause of LRH depends on the subtype.this 2018 study It suggests that it may be the cause:

• Hereditary genetic syndrome
• Acquired gene mutation
• Environmental factors

Your doctor will help you identify the exact cause of your LRH Aldosterone level. Aldosterone levels in your blood can narrow your search for the cause of LRH.

High aldosterone level

If your renin levels are low, but your aldosterone levels are high, you may have Primary aldosteronism.. This is also called hyperaldosteronism or Con syndrome.

Primary aldosteronism is the most common cause of LRH. 2018 survey shows that it affects estimates 6 percent Of people with hypertension.

According to the same 2018 survey, it may be possible for families to do it. Rare hereditary genetic mutations can cause familial hyperaldosteronism.

In some cases, small but benign (non-cancerous) tumors of the adrenal glands can also cause hyperaldosteronism.

Standard aldosterone levels

If aldosterone levels are normal but renin levels are low, the most likely cause is low renin essential hypertension (LREH).This is primary or Essential hypertensionMeans that other health conditions are not the cause of your high blood pressure.

LREH can also be diagnosed if aldosterone is low or high, if other causes are ruled out.

according to 2012 studyLow renin levels are more common in the black community and the elderly.

Low aldosterone levels

If both renin and aldosterone levels are low, research It suggests that there may be some acquired or genetic causes. The acquired causes are as follows.

The genetic causes are:

• Liddle’s syndrome. Liddle’s syndrome It is a rare hereditary disease that causes hypertension due to atypical renal function.
• Mineralocorticoid receptor (MR) activation mutation. this is Hereditary disease It may interfere with your body’s ability to regulate electrolytes. This leads to the inability to regulate your blood pressure.
• Apparent mineralocorticoid excess (AME) syndrome. A 2018 study AME syndrome, a rare disease, has been suggested to be primarily associated with LRH in children.
• Congenital adrenal hyperplasia (CAH). CAH It is a rare hereditary disorder that interferes with adrenal function.
• Glucocorticoid tolerance (Krosos syndrome). Glucocorticoid resistance It is a rare genetic condition that causes insensitivity to glucocorticoids. This can lead to high blood pressure.
• Gordon Syndrome. Gordon Syndrome It is a rare genetic condition that can cause high blood pressure and high potassium levels.

Some of the genetic causes of LRH have a variety of symptoms that do not necessarily lead to high blood pressure.

For example, CAH is a family of classic and non-classical forms of disability.by Philadelphia Children’s HospitalIts classic form is usually low blood pressure. Survey from 2018 It suggests that about two-thirds of people with CAH have low aldosterone LRH.

Symptoms of LRH depend on the underlying cause. But you may not know you have it until your doctor orders a blood test and sees the results.

The National Heart, Lung and Blood Research Institute (NHLBI) Keep in mind that high blood pressure itself does not cause symptoms until it causes serious complications such as heart disease.

other than High blood pressurePrimary aldosteronism is usually associated with weakness Low potassium level Your blood (hypokalemia). This can cause increased thirst, cramps, and weakness.

People with LRH due to primary aldosteronism are also at increased risk of cardiovascular problems. 2012 study.. These include:

Before making a diagnosis of LRH, your doctor will ask you about the symptoms you are experiencing and your personal and family history of high blood pressure. They may also ask you about hereditary disorders that are carried out in your family.

A blood or urine test is required to diagnose LRH. Your doctor looks for the next level:

• Renin, a typical level 1.9 to 3.7 According to the University of California, Los Angeles, nanograms per milliliter per hour (ng / ml / hour)
• Aldosterone determines subtype
• Check for potassium and hypokalemia
• CortisolCheck for steroid production by the adrenal glands

Your doctor may also perform Kidney function test..

In some cases, your doctor will not know the exact cause of your LRH until you see how you react to the drug.

Certain factors can affect renin levels. Your doctor will consider these when assessing your results. 1 2018 study It states that these factors may include:

• Taking certain medicines
• High salt intake
• The first (follicular phase) of the menstrual cycle

Doctors may recommend genetic counseling if certain conditions that may be associated with high blood pressure occur in the family.

You can treat your LRH with a combination of medicines and home management techniques. Surgery may also be required depending on the subtype. The overall goal of treatment is to improve RAAS while lowering blood pressure.

medicine

Dosing options For LRH, it depends on the subtype.by NHLBIOptions may include:

Surgery

To help treat the tumor-induced hyperaldosteronism, doctors may recommend adrenalectomy. In this procedure, the surgeon removes the tumor in the adrenal glands.

Results may vary.However, the Endocrine Society estimates that surgery may help lower blood pressure. 70% or more Of the primary participants Hyperaldosteronism. Some people may also have a reduced need for medications for their blood pressure.

Housing management

Reducing sodium intake can increase LRH blood sodium levels. If you have salt-sensitive hypertension, it may also help.To help you change your diet, your doctor Diet to stop high blood pressure (DASH) Meal plan.

The NHLBI Funded research suggesting that the Dash diet reduces high blood pressure. Survey from 2019 It also shows that this dietary plan may have an antihypertensive effect on RAAS.

Around NHLBIThe DASH Diet focuses on low-salt foods such as:

• fruit
• vegetable
• Whole grains
• nuts
• seed
• Leguminosae

The Dash Diet also allows low-fat poultry, fish and dairy products. The daily intake of sodium should be 1,500-2,300 milligrams per day.

In addition to the dash diet, your doctor may recommend other home care strategies to help control your blood pressure. The NHLBI List lifestyle changes, including:

• Stress management
• no smoking
• Exercise regularly
• Maintain your ideal weight
• Limit alcohol intake
• Get 7-9 hours of sleep every night

LRH is a relatively common subtype of hypertension associated with RAAS. Some cases of low renin are hereditary, but most are acquired and the risk increases with age.

You may not know you have an LRH until your doctor orders you to have a blood test. Like other forms of hypertension, LRH usually does not cause any noticeable symptoms unless associated complications occur.

You can change your diet and lifestyle to help manage LRH. However, depending on the underlying cause, certain medications may be needed. In rare cases, your doctor may recommend surgery.