Mineralocorticoid Receptor Antagonists and the Metabolic Syndrome

• Published in: Current hypertension reports Vol. 12; no. 4; pp. 252 - 257
• Main Authors: Tirosh, Amir, Garg, Rajesh, Adler, Gail K.
• Format: Journal Article
• Language: English
• Published: New York Current Science Inc 01.08.2010; Springer Nature B.V
• Subjects: Aldosterone; Antihypertensive Agents - therapeutic use; Cardiology; Family Medicine; General Practice; Humans; Hypertension; Hypertension - drug therapy; Hypertension - physiopathology; Inflammation - physiopathology; Insulin Resistance; Internal Medicine; Lipid Metabolism; Lipids; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic Syndrome - drug therapy; Metabolic Syndrome - physiopathology; Mineralocorticoid Receptor Antagonists - therapeutic use; Nephrology; Obesity - physiopathology; Primary Care Medicine; Signal Transduction - drug effects; Spironolactone - analogs & derivatives; Spironolactone - therapeutic use; Obesity; Insulin resistance; Spironolactone; Eplerenone; Aldosterone; Mineralocorticoid receptor
• ISSN: 1522-6417; 1534-3111
• DOI: 10.1007/s11906-010-0126-2

Key components of the metabolic syndrome (MetS), ie, obesity and insulin resistance, are associated with increased aldosterone production and mineralocorticoid receptor (MR) activation. Both MetS and hyperaldosteronism are proinflammatory and pro-oxidative states associated with cardiovascular disease. This review discusses emerging data that MR activation may contribute to abnormalities seen in MetS. In view of these data, MR antagonists may be beneficial in MetS, not only by controlling hypertension but also by reversing inflammation, oxidative stress, and defective insulin signaling at the cellular-molecular level. Clinical trials have demonstrated benefits of MR antagonists in heart failure, hypertension, and diabetic nephropathy, but additional trials are needed to demonstrate the clinical significance of MR blockade in MetS.