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Review: Aldosterone Antagonists

Department of Cardiology, Papworth Hospital, UK, krishnankala{at}hotmail.com

Tom Macdonald

Department of Medicine and Therapeutics, Division of Clinical Pharmacology, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK

Diabetes mellitus is a major risk factor for microvascular and macrovascular disease. Many of the deleterious effects of hyperglycaemia are similar to those of aldosterone on the cardiovascular system (CVS). In addition to its classical epithelial effects, aldosterone has a variety of non-epithelial effects including induction of inflammation, collagen formation, fibrosis and necrosis in the CVS. Interest in these effects has recently re-emerged. The three aldosterone antagonists currently licensed for use in the UK are: spironolactone, potassium canrenoate and eplerenone. Eplerenone is a selective aldosterone receptor antagonist. It is a derivative of spironolactone and has the major advantage of a lower incidence of androgenic and progestogenic side effects. Both spironolactone and eplerenone are effective antihypertensive agents and reduce mortality and morbidity in heart failure. They prevent sudden cardiac death. They also exert renoprotective effects. They should be judiciously used in diabetes due to their tendency for hyperkalemia, however, they have proved vital in providing a more complete inhibition of the deleterious effects of renin-angiotensin-aldosterone system (aldosterone antagonists).

Key Words: renin-angiotensin-aldosterone system • aldosterone • spironolactone • eplerenone

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The British Journal of Diabetes & Vascular Disease, Vol. 8, No. 5, 215-219 (2008)
DOI: 10.1177/1474651408094591


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hari Krishnan Parthasarathy Articles by Macdonald, T. Search for Related Content Social Bookmarking                         What's this?