Mineralocorticoid receptor antagonists and endothelial function.
Hyperaldosteronism is associated with endothelial dysfunction and impaired vascular reactivity in patients with hypertension or congestive heart failure. When present, endothelial dysfunction is an independent predictor of adverse cardiovascular events. The mineralocorticoid receptor (MR) antagonists spironolactone and eplerenone reduce morbidity and mortality, and it has been suggested that this occurs, in part, as a result of improved vascular function. The routine use of MR antagonists in patients with cardiovascular disease, however, is limited by the development of gynecomastia with spironolactone use and hyperkalemia with the use of both agents. Therefore, the development of newer agents with more favorable side-effect profiles is needed.
Maron
Bradley A
BA
Harvard Medical School, Brigham and Women's Hospital, Department of Medicine, Cardiovascular Division, 77 Avenue Louis Pasteur, NRB 0630K, Boston, MA 02115, USA.
Leopold
Jane A
JA
D000450:Aldosterone / Q000502:physiology; D000818:Animals; D004700:Endocrine System Diseases / Q000188:drug therapy; D004730:Endothelium, Vascular / Q000187:drug effects*; D000077545:Eplerenone; D006801:Humans; D006929:Hyperaldosteronism / Q000097:blood / Q000188:drug therapy*; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D013148:Spironolactone / Q000031:analogs & derivatives / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use
D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone; D000077545:Eplerenone