Mineralocorticoid receptor blockade in chronic heart failure

The effects of ACE inhibitors on plasma aldosterone in chronic heart failure are poor, variable and unsustained. This is important to recognise because aldosterone has many harmful properties of its own. Aldosterone causes magnesium loss, potentiates catecholamines, induces ventricular arrhythmias, alters baroreflex function and stimulates myocardial fibrosis. Strategies to reduce these effects of aldosterone are being explored.