Adverse Effects of Aldosterone: Beyond Blood Pressure

Aldosterone is a steroid hormone that primarily acts through activation of the mineralocorticoid receptor (MR), a nuclear receptor responsible for downstream genomic regulation. Classically, activation of the MR in the renal tubular epithelium is responsible for sodium retention and volume expansion...

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Published inJournal of the American Heart Association Vol. 13; no. 7; p. e030142
Main Author Brown, Jenifer M
Format Journal Article
LanguageEnglish
Published England John Wiley and Sons Inc 02.04.2024
Wiley
Subjects
Aldosterone
Blood Pressure
Contemporary Review
Contemporary Reviews
Drug-Related Side Effects and Adverse Reactions
Heart
heart failure
Humans
hyperaldosteronism
Hyperaldosteronism - drug therapy
Hypertension
Kidney
mineralocorticoid receptor
Mineralocorticoid Receptor Antagonists - therapeutic use
Receptors, Mineralocorticoid - metabolism
hyperaldosteronism
heart failure
mineralocorticoid receptor
hypertension
aldosterone
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Summary:Aldosterone is a steroid hormone that primarily acts through activation of the mineralocorticoid receptor (MR), a nuclear receptor responsible for downstream genomic regulation. Classically, activation of the MR in the renal tubular epithelium is responsible for sodium retention and volume expansion, raising systemic blood pressure. However, activation of the MR across a wide distribution of tissue types has been implicated in multiple adverse consequences for cardiovascular, cerebrovascular, renal, and metabolic disease, independent of blood pressure alone. Primary aldosteronism, heart failure, and chronic kidney disease are states of excessive aldosterone production and MR activity where targeting MR activation has had clinical benefits out of proportion to blood pressure lowering. The growing list of established and emerging therapies that target aldosterone and MR activation may provide new opportunities to improve clinical outcomes and enhance cardiovascular and renal health.
Bibliography:ObjectType-Article-2
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For Sources of Funding and Disclosures, see page 11.
This manuscript was sent to J. David Spence, BA, MBA, MD, Guest Editor, for review by expert referees, editorial decision, and final disposition.
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.123.030142