Nonclassic endocrine hypertension

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The term endocrine hypertension traditionally refers to hypertensive syndromes usually caused by adrenal hormone hypersecretion. Two recent nontraditional syndrome?, 11 β-hydroxysteroid dehydrogenase deficiency and Na+/K+-ATPase inhibition, also have been linked to adrenal dysfunction. 11 β-Hydroxysteroid dehydrogenase deficiency is an unusual genetic syndrome of mineralocorticoid hypertension in children caused by reduced activity of this guardian enzyme at the renal mineral corticoid receptor and illicit interaction of circulating cortisol with the receptor. Licorice and derivatives produce a similar hypertensive syndrome by the same mechanism, and some essential hypertensive patients also may have a mild defect in this enzyme. Inhibition of Na+/K+-ATPase by a circulating ouabain-like material may cause hypertension. Ouabain itself, produced by the adrenal glands, has been proposed as an important hormone of this syndrome. Hence, these two atypical forms of endocrine hypertension have expanded the definition of the disorder.

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