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The British Journal of Diabetes & Vascular Disease
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Review: Aldosterone — the future challenge in cardiovascular disease?

John Connell

MRC Blood Pressure Group, Division of Cardiovascular and Medical Sciences, University of Glasgow, Western Infirmary, Glasgow, G11 6NT, UK, Jmcc1m{at}clinmed.gla.ac.uk

Mineralocorticoid receptor activation plays a key role in cardiovascular disease and hypertension, which are particularly prevalent in diabetes mellitus; secondary hyperaldosteronism contributes to cardiac failure. Major intervention trials in heart failure have demonstrated unequivocal benefit from aldosterone receptor antagonism. Focused experimental studies in humans and in animal models of hypertension have shown that aldosterone blockade improves a number of pathogenic abnormalities including vascular endothelial dysfunction and altered baroreflex function, and prevents the development of cardiac hypertrophy and renal histological damage. Based on recent outcomes studies, the challenge is now to transfer the experimental evidence into clinical M practice.

Key Words: aldosterone • spironolactone • eplerenone • angiotensin receptor antagonist.

The British Journal of Diabetes & Vascular Disease, Vol. 4, No. 6, 370-376 (2004)
DOI: 10.1177/14746514040040060201
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