Hipertensión arterial mineralocorticoidea

Mineralocorticoid-dependent hypertension is a common form of secondary hypertension that encompasses various disorders sharing a common feature: hyperactivation of the mineralocorticoid receptor. The most relevant causes include primary aldosteronism (PA), 11β-hydroxysteroid dehydrogenase type 2 (11β-HSD2) deficiency, and the hypertensive forms of classic congenital adrenal hyperplasia. PA is an adrenal disorder characterized by inappropriate aldosterone production that is independent of its physiological regulators. It is a frequent cause of secondary hypertension and is associated with higher cardiovascular risks compared to primary (essential) hypertension. Despite the availability of effective diagnostic and therapeutic methods, PA remains underdiagnosed, preventing many patients from receiving personalized, effective, and potentially curative treatments. The aim of this review is to provide healthcare professionals managing patients with arterial hypertension with an updated and practical overview of the main causes of mineralocorticoid-dependent secondary hypertension, with a particular focus on PA. It addresses its pathophysiology, diagnostic criteria, genetic advances, and therapeutic strategies, with the goal of improving its detection and timely management in clinical practice, ultimately reducing the associated morbidity and mortality burden.