Aldosterone Synthase Inhibition in Hypertension
Abstract
Hypertension is an established risk factor for stroke, premature coronary artery disease and heart failure. Control of elevated blood pressure has been shown to result in significant reduction of cardiovascular risk. Aldosterone, the final product of the renin-angiotensin-aldosterone system (RAAS), not only causes salt and water reabsorbtion in the kidneys through its effect on the mineralocorticoid hormone receptor (MR), but also an MR-independent effect, not regulated by conventional MR blockade. Although many pharmacological agents target different levels of the RAAS cascade, these generally result in elevated renin concentration and plasma renin activity. This upstream feedback response subsequently results in elevated levels of angiotensin II, a potent vasoconstrictor and stimulus to aldosterone release. This aldosterone breakthrough counteracts the long-term blood pressure-lowering effect of these agents. Therefore the development of a new class of pharmacologic agents that directly inhibit the production of aldosterone may prove clinically useful in reducing aldosterone and thereby controlling elevated blood pressure.
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Aldosterone synthase inhibitors attenuate cardiac and renal injury in models of experimental hypertension such as spontaneously hypertensive rats and uninephrectomized rats fed a high-salt diet.
“Aldosterone synthase inhibitors have been shown to attenuate cardiac and renal injury in models of experimental hypertension, such as spontaneously hypertensive rats (SHRs) and uninephrectomized rats fed a high-salt diet77,78, but their efficacy in obesity-induced hypertension is unclear.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [77]
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Obesity, kidney dysfunction and hypertension: mechanistic links
Hall, J. E., do Carmo, J. M., da Silva, A. A., Wang, Z., & Hall, M. E. (2019) · Nature Reviews Nephrology · doi:10.1038/s41581-019-0145-4 · Cited by 654 · see citing works
- Authors
- Andersen, K.
- Affiliations
- National University Hospital of Iceland (IS)
- Corresponding author
- Andersen, Karl
- ORCID
- Andersen, Karl
- Venue
- Current Hypertension Reports
- Published
- 2013-08-06
- Volume
- 15
- Issue
- 5
- Pages
- 484-488
- ISSN
- 1522-6417 (ISSN-L)
- 1534-3111
- OpenAlex
- W2044305216
- Cited by
- 12
- References
- 49
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 1 · 2022: 1 · 2019: 1 · 2017: 1 · 2016: 1 · 2015: 4
- FWCI
- 0.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Hypertension Reports (publishedVersion)
- PubMed (publishedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- aldosterone synthase inhibition, hypertension, renin-angiotensin-aldosterone system, mineralocorticoid receptor, renin-angiotensin system blockade, angiotensin II, blood pressure control, cardiovascular risk
- MeSH terms
- Aldosterone, Animals, Antihypertensive Agents, Enzyme Inhibitors, Humans, Hypertension, Renin-Angiotensin System, Cytochrome P-450 CYP11B2
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