Aldosterone synthase inhibitors in cardiovascular and renal diseases
Open accessAbstract
Aldosterone is involved in various cardiovascular pathologies, including hypertension, heart failure, atherosclerosis and fibrosis. Mineralocorticoid receptor (MR)-dependent and -independent, genomic and non-genomic processes mediate its complex effects. Spironolactone and eplerenone, both MR antagonists, are the only commercially available compounds targeting directly the actions of aldosterone. However, due to the poor selectivity (spironolactone), low potency (eplerenone) and the fact that only MR-dependent effects of aldosterone can be inhibited, these drugs have limited clinical use. An attractive approach to abolish potentially all of aldosterone-mediated pathologies is the inhibition of aldosterone synthase. This review summarizes current knowledge on the complex effects mediated by aldosterone, potential advantages and disadvantages of aldosterone inhibition and novel directions in the development of aldosterone synthase inhibitors.
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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 [78]
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New Therapies for the Management of Chronic Kidney Disease
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Aldosterone synthase inhibition for treatment of people with chronic kidney disease
Tuttle, K. R., Stankovic, J. T., Alicic, R. Z., Caramori, M. L., Cherney, D. Z. I., Rotter, R. C., Herrington, W. G., Judge, P. K., Levin, A., & Rossing, P. R. (2026) · Clinical Kidney Journal · doi:10.1093/ckj/sfag229
- Authors
- Namsolleck, P., & Unger, T.
- Affiliations
- Maastricht University (NL)
- Corresponding author
- Unger, T.
- ORCID
- Unger, T.
- Venue
- Nephrology Dialysis Transplantation
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-02-01
- Volume
- 29
- Issue
- suppl 1
- Pages
- i62-i68
- ISSN
- 0931-0509 (ISSN-L)
- 1460-2385
- OpenAlex
- W2105712276
- Cited by
- 63
- References
- 42
- Citations by year
- 2026: 2 · 2025: 13 · 2024: 5 · 2023: 5 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 9 · 2015: 9 · 2014: 7
- FWCI
- 1.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nephrology Dialysis Transplantation (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- 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 › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
- Keywords
- aldosterone synthase inhibitors, aldosterone, mineralocorticoid receptor antagonists, spironolactone, eplerenone, hypertension, heart failure, atherosclerosis, fibrosis, kidney disease, cardiovascular disease
- MeSH terms
- Mineralocorticoid Receptor Antagonists, Animals, Cardiovascular Diseases, Humans, Kidney Diseases, Cytochrome P-450 CYP11B2
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