Physiology of aldosterone and pharmacology of aldosterone blockers

European Heart Journal, Supplement

Volumn 13, Issue SUPPL. B, 2011, Pages

  Struthers, Allan D ^a   Unger, Thomas ^b  

^a UNIVERSITY OF DUNDEE   (United Kingdom)

^b CHARITÉ UNIVERSITÄTSMEDIZIN BERLIN   (Germany)

Author keywords

Aldosterone blocker; Eplerenone; Heart failure; Hypertension; Pharmacology; Spironolactone

Indexed keywords

ALDOSTERONE; ALDOSTERONE ANTAGONIST; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; ENZYME INHIBITOR; EPLERENONE; FAD 286; SPIRONOLACTONE; SPP 2745; UNCLASSIFIED DRUG;

ACUTE HEART INFARCTION; ARTICLE; DRUG ACTIVITY; DRUG HALF LIFE; GYNECOMASTIA; HEART FAILURE; HUMAN; HYPERTENSION; MENSTRUATION DISORDER; MORTALITY; NONHUMAN; PATHOPHYSIOLOGY; PRIORITY JOURNAL;

EID: 79959514859     PISSN: 1520765X     EISSN: 15542815     Source Type: Journal    
DOI: 10.1093/eurheartj/sur009     Document Type: Article

References (23)

1. Struthers AD. The clinical implications of aldosterone escape in congestive heart failure. Eur J Heart Fail 2004;6:539-545. (Pubitemid 39070505)
2. Farquharson CA, Struthers AD. Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure. Circulation 2000;101:594-597. (Pubitemid 30094728)
3. Macdonald JE, Kennedy N, Struthers AD. Effects of spironolactone on endothelial function, vascular angiotensin converting enzyme activity, and other prognostic markers in patients with mild heart failure already taking optimal treatment. Heart 2004;90:765-770. (Pubitemid 38813637)
4. Rajagopalan S, Duquaine D, King S, Pitt B, Patel P. Mineralocorticoid receptor antagonism in experimental atherosclerosis. Circulation 2002;105:2212-2216. (Pubitemid 34517167)
5. Bauersachs J, Heck M, Fraccarollo D, Hildemann SK, Ertl G, Wehling M, Christ M. Addition of spironolactone to angiotensinconverting enzyme inhibition in heart failure improves endothelial vasomotor dysfunction: role of vascular superoxide anion formation and endothelial nitric oxide synthase expression. J Am Coll Cardiol 2002;39:351-358. (Pubitemid 34084645)
6. Brilla CG, Matsubara LS, Weber KT. Anti-aldosterone treatment and the prevention of myocardial fibrosis in primary and secondary hyperaldosteronism. J Mol Cell Cardiol 1993;25:563-575. (Pubitemid 23208145)
7. MacFadyen RJ, Barr CS, Struthers AD. Aldosterone blockade reduces vascular collagen turnover, improves heart rate variability and reduces early morning rise in heart rate in heart failure patients. Cardiovasc Res 1997;35:30-34. (Pubitemid 27374737)
8. Zannad F, Alla F, Dousset B, Perez A, Pitt B. Limitation of excessive extracellular matrix turnover may contribute to survival benefit of spironolactone therapy in patients with congestive heart failure: insights from the Randomized Aldactone Evaluation Study (RALES). RALES Investigators. Circulation 2000;102:2700-2706.
9. Wang W, McClain JM, Zucker IH. Aldosterone reduces baroreceptor discharge in the dog. Hypertension 1992;19:270-277.
10. Yee KM, Pringle SD, Struthers AD. Circadian variation in the effects of aldosterone blockade on heart rate variability and QT dispersion in congestive heart failure. J Am Coll Cardiol 2001;37:1800-1807. (Pubitemid 32499962)
11. Rocha R, Stier CT Jr. Pathophysiological effects of aldosterone in cardiovascular tissues. Trends Endocrinol Metab 2001;12:308-314. (Pubitemid 33714222)
12. Brown NJ, Kim KS, Chen YQ, Blevins LS, Nadeau JH, Meranze SG, Vaughan DE. Synergistic effect of adrenal steroids and angiotensin II on plasminogen activator inhibitor-1 production. J Clin Endocrinol Metab 2000;85:336-344. (Pubitemid 32268835)
13. Wehling M, Spes CH, Win N, Janson CP, Schmidt BM, Theisen K, Christ M. Rapid cardiovascular action of aldosterone in man. J Clin Endocrinol Metab 1998;83:3517-3522. (Pubitemid 28500882)
14. Struthers A, Krum H, Williams GH. A comparison of the aldosteroneblocking agents eplerenone and spironolactone. Clin Cardiol 2008; 31:153-158. (Pubitemid 351556480)
15. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999;341: 709-717. (Pubitemid 29407370)
16. Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, Bittman R, Hurley S, Kleiman J, Gatlin M. Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study Investigators. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003;348:1309-1321. (Pubitemid 36384098)
17. Wei L, Struthers AD, Fahey T, Watson AD, Macdonald TM. Spironolactone use and renal toxicity: population based longitudinal analysis. BMJ 2010;340:c1768.
18. Boccanelli A, Mureddu GF, Cacciatore G, Clemenza F, Di Lenarda A, Gavazzi A, Porcu M, Latini R, Lucci D, Maggioni AP, Masson S, Vanasia M, de Simone G. AREA IN-CHF Investigators. Antiremodelling effect of canrenone in patients with mild chronic heart failure (AREA IN-CHF study): final results. Eur J Heart Fail 2009;11:68-76.
19. Muldowney JA 3rd, Schoenhard JA, Benge CD. The clinical pharmacology of eplerenone. Expert Opin Drug Metab Toxicol 2009;5: 425-432.
20. Yamaji M, Tsutamoto T, Kawahara C, Nishiyama C, Yamamoto T, Fujii M, Horie M. Effect of eplerenone versus spironolactone on cortisol and hemoglobin A1c levels in patients with chronic heart failure. Am Heart J 2010;160:915-921.
21. Gerstein HC, Swedberg K, Carlsson J, McMurray JJ, Michelson EL, Olofsson B, Pfeffer MA, Yusuf S. CHARM Program Investigators. The hemoglobin A1c level as a progressive risk factor for cardiovascular death, hospitalization for heart failure, or death in patients with chronic heart failure: an analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and Morbidity (CHARM) program. Arch Intern Med 2008;168: 1699-704.
22. Paulis L, Unger T. Novel therapeutic targets for hypertension. Nat Rev Cardiol 2010;7:431-441.
23. Dorn GW 2nd. Novel pharmacotherapies to abrogate postinfarction ventricular remodeling. Nat Rev Cardiol 2009;6:283-291.