Aldosterone in heart failure: pathophysiology and treatment.
Aldosterone produces adverse effects on the vasculature (endothelial dysfunction) and on the myocardium (myocardial fibrosis). These effects have adverse clinical consequences that result in increases in deaths caused by sudden death and by progressive heart failure. The Randomized Aldactone Evaluation Study and the Eplerenone Post-acute Myocardial Infarction Heart Failure Efficacy and Survival Study show this clearly. Aldosterone blockade should become a regular third neuroendocrine-blocking drug in patients with chronic heart failure.
Struthers
Allan D
AD
Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. a.d.struthers@dundee.ac.uk
D000450:Aldosterone / Q000502:physiology*; D016757:Death, Sudden, Cardiac; D004730:Endothelium, Vascular / Q000503:physiopathology; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D009206:Myocardium / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D020257:Ventricular Remodeling / Q000502:physiology
D000451:Mineralocorticoid Receptor Antagonists; D000450:Aldosterone