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Glucocorticoid remediable aldosteronism (GRA) screening in hypertensive patients from a primary care setting

Journal of Human Hypertension volume 19, pages 325–327 (2005)Cite this article

Glucocorticoid Remediable Aldosteronism (GRA), also known as familial hyperaldosteronim type I (FH-I) is a form of inherited hypertension, transmitted as an autosomal dominant trait. The syndrome is characterised by high levels of aldosterone, suppressed plasma renin activity, high incidence of intracranial haemorrhage, and paradoxical sensitivity to glucocorticoid therapy. Not all patients develop sporadic hypokalaemia, and are often normokalaemic.

The pathogenetic mechanism derives from an asymmetrical crossing-over with a nonreciprocal recombination between the 11β-hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2) genes. The resulting chimaeric gene has 5′ regulatory elements of CYP11B1 fused to 3′ coding sequences of CYP11B2. The preferential expression of this mutant form of CYP11B2 drives a transcription process under the control of ACTH instead of physiological angiotensin II stimulus.1

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Acknowledgements

We are grateful to the following General Practitioners for their important contribution in the data collection and patients recruitment: Paolo Adami, Carlo Ballarini, Anna Barbera, Gaetano Benati, Bruno Benedetti, Claudio Bertaiola, Tiziano Bonaldi, Annarosa Bovo, Umberto Cacchi, Marco Cherubini, Damiano Chiesa, Massimo Chincarini, Giorgio Ciampalini, Roberto Ciresa, Giuseppe Coccia, Chiara Cressoni, Giuliana Dal Pozzo, Roberto Esposti, Francesco Faraci, Marina Ferrarini, Guido Filippini, Anna Fioretta, Adelheid Fischer, Carlo Andrea Franchini, Guglielmo Frapporti, Federica Galvani, Beatrice Gargiulo, Angelo Garofalo, Walter Idolazzi, Giorgio Laciniati, Moreno Leoncini, Livio Libardi, Serena Losi, Italo Lovato, Silvio Mantovani, Raffaella Marrocchella, Innocenzo Maurelli, Marco Pietro Mazzi, Silvia Menegazzi, Ernesto Menini, Alessio Micchi, Mauro Montana, Osvaldo Morbioli, Franco Motta, Antonio Panzino, Adriano Ramanzini, Giandomenico Righetti, Arianna Rizzi, Rudi Santini, Gustavo Sartori, Paolo Scarpolini, Francesco Schiera, Maurizio Sciortino, Alessandro Severi, Lionello Signorati, Cesare Testi, Mariella Varaschin, Matteo Venturi. We are also thankful to Denise Signorelli, Salvatore Falcone, Chiara Pavan, Giorgio Parise for the valuable help in collecting data. This work was supported by grants from the Italian Ministry for Scientific Research and Technology, and Regione Veneto Ricerca Finalizzata, Venezia Italia.

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Authors and Affiliations

  1. Unit of Internal Medicine, Department of Clinical and Experimental Medicine, University of Verona, Italy

    F Pizzolo, P Guarini, R Corrocher & O Olivieri

  2. Department of Mother and Child, Biology and Genetics, University of Verona, Italy

    E Trabetti

  3. Hypertension Unit, Department of Medicine and Experimental Oncology, University of Turin, Italy

    P Mulatero

  4. General Practitioner, Bussolengo, Italy

    A Ciacciarelli

  5. Service of Epidemiology, Bussolengo Health District, Italy

    G S Blengio

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Correspondence to F Pizzolo.

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Pizzolo, F., Trabetti, E., Guarini, P. et al. Glucocorticoid remediable aldosteronism (GRA) screening in hypertensive patients from a primary care setting. J Hum Hypertens 19, 325–327 (2005). https://doi.org/10.1038/sj.jhh.1001821

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