[Aldosterone antagonists: hypotensive and natriuretic drugs]

Antimineralocorticoid drugs are widely prescribed as hypertensive agents, with an efficacy comparable to other drugs (thiazide diuretics, beta-blockers), especially in low-renin hypertension. However they require a prolonged lag-time (several weeks) in order to obtain maximal hypotensive effect. There is no hypokalemia and its possible cardiac and metabolic consequences. They are sometimes responsible for dose-dependent sexual side effect. Knowing the pathophysiology of these effects as well as the precise renal and extra-renal mechanism of action of antimineralocorticoids should lead to the discovery of new specific, efficient and safe compounds for which there is need in the management of hypertension.