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Mineralocorticoid Receptors in Vascular Disease: Connecting Molecular Pathways to Clinical Implications

  • Clinical Trials and Their Interpretation (J Plutzky, Section Editor)
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Abstract

The mineralocorticoid receptor (MR), a steroid-hormone-activated transcription factor, plays a substantial role in cardiovascular diseases. MR antagonists (MRAs) have long been appreciated as effective treatments for heart failure and hypertension; however, recent research suggests that additional patient populations may also benefit from MRA therapy. Experimental evidence demonstrates that in addition to its classic role in the regulating sodium handling in the kidney, functional MR is expressed in the blood vessels and contributes to hypertension, vascular inflammation and remodeling, and atherogenesis. MR activation drives pathological phenotypes in smooth muscle cells, endothelial cells, and inflammatory cells, whereas MRAs inhibit these effects. Collectively, these studies demonstrate a new role for extrarenal MR in cardiovascular disease. This review summarizes these new lines of evidence and how they contribute to the mechanisms of atherosclerosis, pulmonary and systemic hypertension, and vein graft failure, and describes new patient populations that may benefit from MRA therapy.

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Conflict of Interest

Adam P. McGraw declares no conflict of interest.

Amy McCurley declares no conflict of interest.

Ioana R. Preston declares no conflict of interest.

Iris Z. Jaffe declares no conflict of interest.

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Authors and Affiliations

  1. Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Boston, MA, USA

    Adam P. McGraw, Amy McCurley & Iris Z. Jaffe

  2. Division of Pulmonary, Critical Care, and Sleep, Tufts Medical Center, 800 Washington Street, Boston, MA, USA

    Ioana R. Preston

  3. Division of Cardiology, Tufts Medical Center, 800 Washington Street, Boston, MA, USA

    Iris Z. Jaffe

  4. Sackler School of Graduate Biomedical Sciences, Tufts University School of Medicine, 145 Harrison Avenue, Boston, MA, USA

    Iris Z. Jaffe

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  1. Adam P. McGraw
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Correspondence to Iris Z. Jaffe.

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This article is part of the Topical Collection on Cardiovascular Disease and Stroke

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McGraw, A.P., McCurley, A., Preston, I.R. et al. Mineralocorticoid Receptors in Vascular Disease: Connecting Molecular Pathways to Clinical Implications. Curr Atheroscler Rep 15, 340 (2013). https://doi.org/10.1007/s11883-013-0340-x

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