Article

Current Hypertension Reports

, Volume 12, Issue 4, pp 252-257

Mineralocorticoid Receptor Antagonists and the Metabolic Syndrome

  • Amir TiroshAffiliated withDivision of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School
  • , Rajesh GargAffiliated withDivision of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School
  • , Gail K. AdlerAffiliated withDivision of Endocrinology, Diabetes and Hypertension, Brigham and Women’s Hospital, Harvard Medical School Email author 

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Abstract

Key components of the metabolic syndrome (MetS), ie, obesity and insulin resistance, are associated with increased aldosterone production and mineralocorticoid receptor (MR) activation. Both MetS and hyperaldosteronism are proinflammatory and pro-oxidative states associated with cardiovascular disease. This review discusses emerging data that MR activation may contribute to abnormalities seen in MetS. In view of these data, MR antagonists may be beneficial in MetS, not only by controlling hypertension but also by reversing inflammation, oxidative stress, and defective insulin signaling at the cellular-molecular level. Clinical trials have demonstrated benefits of MR antagonists in heart failure, hypertension, and diabetic nephropathy, but additional trials are needed to demonstrate the clinical significance of MR blockade in MetS.

Keywords

Aldosterone Mineralocorticoid receptor Obesity Insulin resistance Spironolactone Eplerenone