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Aldosterone and its blockade: a cardiovascular and renal perspective
V Lahera1, V Cachofeiro, G Balfagon
1Department of Physiology, School of Medicine, Universidad Complutense, Madrid, Spain.
Thescientificworldjournal
|April 11, 2006
Summary
Aldosterone contributes to cardiovascular and renal damage, especially with high salt intake. Mineralocorticoid-receptor antagonists show therapeutic benefits in managing related conditions like hypertension and heart failure.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Nephrology
Background:
- Aldosterone plays a role in salt and water balance, but also directly impacts cardiovascular and renal systems.
- Aldosterone is implicated in cardiac alterations linked to hypertension, heart failure, and diabetes.
- Dietary salt intake significantly influences aldosterone-mediated cardiovascular damage.
Purpose of the Study:
- To review the pathophysiological actions of aldosterone in cardiovascular and renal diseases.
- To highlight the role of extra-adrenal aldosterone production.
- To discuss the therapeutic potential of mineralocorticoid-receptor (MR) antagonists.
Main Methods:
- Review of experimental and clinical studies on aldosterone's effects.
- Analysis of data from clinical trials (e.g., RALES, EPHESUS, 4E) involving MR antagonists.
- Examination of aldosterone's local production in extra-adrenal tissues.
Main Results:
- Aldosterone contributes to fibrosis, inflammation, oxidative stress, endothelial dysfunction, and cell proliferation.
- Extra-adrenal aldosterone production in the heart and brain blood vessels is significant.
- MR antagonists, alone or with other therapies, reduce organ damage and hospitalizations in hypertensive and heart failure patients.
Conclusions:
- Aldosterone has detrimental cardiovascular and renal effects, exacerbated by high salt intake.
- Local aldosterone production contributes to its pathological actions.
- MR antagonists are clinically beneficial in managing aldosterone-related target organ damage.
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