Adrenal Corticosteroids, Their Receptors And Hypertension

Mineralocorticoids and glucocorticoids are primarily synthesized in the adrenal cortex, and play key roles in mediating physiological responses under stressful conditions, such as lack of water or nutrients. Both types of corticosteroid elevate blood pressure and elevated levels of these steroids are found in hypertensive patients. The major mineralocorticoid and glucocorticoid in humans are alcosterone and cortisol, respectively. Alclosterone activates the mineralocorticoid receptor (MR) and cortisol the glucocorticoid receptor (GR). In this overview, the clinical and genetic evidence that both MR and GR are involved in blood pressure regulation is reviewed as are the mechanisms by which MR and GR regulate blood pressure in response to agonists. MR antagonists have been used to treat hypertension. However, GR antagonists have not been fully explored in the clinic. Based on the prevalence of abnormal mineralocorticoid and glucocorticoid signaling in hypertension patients, it is proposed that antagonizing these adrenal corticosteroid receptors will provide benefit in treating hypertension.