title: Mineralocorticoid antagonism: a novel way to treat sarcopenia and physical impairment in older people?
abstract: Dysregulation of the renin-angiotensin-aldosterone system has been associated with a number of age-related pathologies including hypertension, heart failure and chronic kidney disease. More recently, it has been suggested that alterations within the RAAS may contribute to the development of sarcopenia and subsequent decline in physical function. There is growing interest in developing interventions to prevent age-associated decline in muscle function. We postulate that inhibition of the RAAS with the mineralocorticoid antagonist spironolactone may have a role in countering the effects of physical impairment in older people by improving skeletal muscle function. Spironolactone may prevent skeletal myocyte apoptosis, improve vascular endothelial function and enhance muscle contractility by increasing muscle magnesium and sodium-potassium pumps. This article will review the literature underpinning the hypothesis that spironolactone may have a role in maintaining muscle function in older people.
authors.affiliation: Section of Ageing and Health, Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. louiseburton@nhs.net
authors.forename: Louise A
authors.initials: LA
authors.lastname: Burton
authors.forename: Marion E T
authors.initials: ME
authors.lastname: McMurdo
authors.forename: Allan D
authors.initials: AD
authors.lastname: Struthers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000187:drug effects / Q000502:physiology; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D051346:Mobility Limitation; D009043:Motor Activity / Q000187:drug effects*; D012149:Restraint, Physical / Q000502:physiology; D055948:Sarcopenia / Q000188:drug therapy*; D013148:Spironolactone / Q000627:therapeutic use
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone