title: Aldosterone and arterial hypertension.
abstract: In the setting of primary aldosteronism, elevated aldosterone levels are associated with increased blood pressure. Aldosterone concentrations within the normal range, however, can also alter blood pressure. Furthermore, the aldosterone-to-renin ratio, an indicator of aldosterone excess, is associated with hypertension, even in patients without excessive absolute aldosterone levels. In this Review we assess the data on the role of aldosterone in the development and maintenance of hypertension. We provide an overview of the complex crosstalk between genetic and environmental factors, and about aldosterone-mediated arterial hypertension and target organ damage. The discussion is organized according to major targets of aldosterone action: the collecting duct in the kidney, the vasculature and the central nervous system. The antihypertensive efficacy of mineralocorticoid-receptor blockers, even in patients with aldosterone values in the normal range, supports the evidence that aldosterone plays a part in blood pressure elevation in the absence of primary aldosteronism.
authors.affiliation: Division of Endocrinology and Nuclear Medicine, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria. andreas.tomaschitz@gmx.at
authors.forename: Andreas
authors.initials: A
authors.lastname: Tomaschitz
authors.forename: Stefan
authors.initials: S
authors.lastname: Pilz
authors.forename: Eberhard
authors.initials: E
authors.lastname: Ritz
authors.forename: Barbara
authors.initials: B
authors.lastname: Obermayer-Pietsch
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Pieber
mesh_terms: D000450:Aldosterone / Q000235:genetics / Q000494:pharmacology / Q000502:physiology; D000818:Animals; D000959:Antihypertensive Agents; D001794:Blood Pressure; D001808:Blood Vessels / Q000187:drug effects; D001921:Brain / Q000187:drug effects; D019405:Cytochrome P-450 CYP11B2 / Q000235:genetics; D005006:Ethnicity; D020022:Genetic Predisposition to Disease; D006706:Homeostasis; D006801:Humans; D006929:Hyperaldosteronism; D006973:Hypertension / Q000209:etiology / Q000235:genetics; D007685:Kidney Tubules, Collecting / Q000187:drug effects; D000451:Mineralocorticoid Receptor Antagonists; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System
chemical_list: D000959:Antihypertensive Agents; D000451:Mineralocorticoid Receptor Antagonists; D000450:Aldosterone; D019405:Cytochrome P-450 CYP11B2; D012083:Renin