9. Monogenic forms of hypertension
Since publication of our review in 2000 [14] there has been considerable progress in the area of rare Mendelian forms of hypertension. These syndromes account for less than 1% of human hypertension and because a clear and often treatable reason has been elucidated, do not immediately explain the genetics of essential hypertension. However, the Mendelian forms of hypertension are important because they constitute the archetype of hereditable hypertension; demonstrate the importance of genes expressed in the kidney and responsible for salt and water handling in the pathogenesis of hypertension; and may help to unravel mechanisms that also apply to the pathogenesis of essential hypertension. Mendelian forms of hypertension have been reviewed recently [6], [79] and [91] and are summarised in Table 1. It should be noted that there are additional syndromes that would go beyond the scope of this review. For instance, loss-of-function mutations in the aldosterone synthase gene (CYP11B2) can lead to reduced aldosterone levels, hypovolaemia, hypotension and shock [92], [93] and [94]. Other examples include familiar hyperaldosteronism type II, congenital adrenal hyperplasia, mutations in the PPARG gene and hypertension and bradydactyly [6], [79] and [91]. Some of these syndromes can be caused by mutations in several genes, some have not yet been localised to a gene, or have been localised but still lack understanding of the mechanisms that lead to hypertension.
9. Monogenic forms of hypertensionSince publication of our review in 2000 [14] there has been considerable progress in the area of rare Mendelian forms of hypertension. These syndromes account for less than 1% of human hypertension and because a clear and often treatable reason has been elucidated, do not immediately explain the genetics of essential hypertension. However, the Mendelian forms of hypertension are important because they constitute the archetype of hereditable hypertension; demonstrate the importance of genes expressed in the kidney and responsible for salt and water handling in the pathogenesis of hypertension; and may help to unravel mechanisms that also apply to the pathogenesis of essential hypertension. Mendelian forms of hypertension have been reviewed recently [6], [79] and [91] and are summarised in Table 1. It should be noted that there are additional syndromes that would go beyond the scope of this review. For instance, loss-of-function mutations in the aldosterone synthase gene (CYP11B2) can lead to reduced aldosterone levels, hypovolaemia, hypotension and shock [92], [93] and [94]. Other examples include familiar hyperaldosteronism type II, congenital adrenal hyperplasia, mutations in the PPARG gene and hypertension and bradydactyly [6], [79] and [91]. Some of these syndromes can be caused by mutations in several genes, some have not yet been localised to a gene, or have been localised but still lack understanding of the mechanisms that lead to hypertension.
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