Skip to main content
SpringerLink
Log in

Aldosterone and vascular damage

  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Although the aldosterone escape mechanism is well known, aldosterone has often been neglected in the pathophysiologic consequences of the activated renin-angiotensinaldosterone system in arterial hypertension and chronic heart failure. There is now evidence for vascular synthesis of aldosterone aside from its secretion by the adrenal cortex. Moreover, aldosterone is involved in vascular smooth muscle cell hypertrophy and hyperplasia, as well as in vascular matrix impairment and endothelial dysfunction. The mechanisms of action of aldosterone may be either delayed (genomic) or rapid (nongenomic). Deleterious effects of aldosterone leading to vascular target-organ damage include (besides salt and water retention) decreased arterial and venous compliance, increased peripheral vascular resistance, and impaired autonomic vascular control due to baroreflex dysfunction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Brunner HR, Laragh JH, Baer L, et al.: Essential hypertension: renin and aldosterone, heart attack and stroke. N Engl J Med 1972, 286:441–449.

    Article  PubMed  CAS  Google Scholar 

  2. Langford HG, Snavely JR: Effect of DOCA on development of renoprival hypertension. Am J Physiol 1959, 196:449–450.

    PubMed  CAS  Google Scholar 

  3. Klein K, Henk W: Klinisch-experimentelle Untersuchungen über den Einfluss von Aldosteron auf Haemodynamik und Gerinnung. Z Kreisl Forsch 1964, 52:40–53.

    Google Scholar 

  4. Young M, Fullerton M, Dilley R, Funder J: Mineralocorticoids, hypertension and cardiac fibrosis. J Clin Invest 1994, 93:2578–2583.

    Article  PubMed  CAS  Google Scholar 

  5. Slight SH, Joseph J, Ganjam VK, Weber KT: Extra-adrenal mineralocorticoids and cardiovascular tissue. J Mol Cell Cardiol 1999, 31:1175–1184. Provides a comprehensive description of the action of extra-adrenal mineralocorticoids on the cardiovascular tissue.

    Article  PubMed  CAS  Google Scholar 

  6. Tobian L, Redleaf PD: Effect of hypertension on arterial wall electrolytes during deoxycorticosterone administration. Am J Physiol 1957, 189:451–454.

    PubMed  CAS  Google Scholar 

  7. Hansen TR, Bohr DF: Hypertension, transmural pressure, and vascular smooth muscle response in rats. Circ Res 1975, 36:590–598.

    PubMed  CAS  Google Scholar 

  8. Kornel L: The role of vascular steroid receptors in the control of vascular contractility and peripheral vascular resistance. J Steroid Biochem Mol Biol 1993, 45:195–203.

    Article  PubMed  CAS  Google Scholar 

  9. Funder JW, Pearce PT, Smith R, Campbell J: Vascular type I aldosterone binding sites are physiological mineralocorticoid receptors. Endocrinology 1989, 125:2224–2226.

    Article  PubMed  CAS  Google Scholar 

  10. Hatakeyama H, Miyamori I, Fujita T, et al.: Vascular aldosterone: biosynthesis and a link to angiotensin II-induced hypertrophy of vascular smooth muscle cells. J Biol Chem 1994, 269:24316–24320.

    PubMed  CAS  Google Scholar 

  11. Takeda Y, Miyamori I, Inaba S et al.: Vascular aldosterone in genetically hypertensive rats. Hypertension 1997, 29:45–48. Reports that aldosterone is synthesized and cytochrome P450 aldo mRNA exists in the vasculature. Vascular aldosterone contributes to the pathophysiology in hypertension.

    PubMed  CAS  Google Scholar 

  12. Kornel L, Smoszna-Konaszewska B: Aldosterone increases transmembrane influx of Na+ in vascular smooth muscle cells through increased synthesis of Na+ channels. Steroids 1995, 60:114–119.

    Article  PubMed  CAS  Google Scholar 

  13. Christ M, Gunther A, Heck M, et al.: Aldosterone, not estradiol, is the physiological agonist for rapid increases in cAMP in vascular smooth muscle cells. Circulation 1999, 99:1485–1491.

    PubMed  CAS  Google Scholar 

  14. Ullian ME, Walsh LG, Morinelli TA: Potentiation of angiotensin II action by corticosteroids in vascular tissue. Cardiovasc Res 1996, 32:266–273.

    Article  PubMed  CAS  Google Scholar 

  15. Struthers AD: Two new culprits in cardiovascular disease: QT dispersion and aldosterone. J Hum Hypertens 1995, 9:659–661.

    PubMed  CAS  Google Scholar 

  16. Taddei S, Virdis A, Mattei P, Salvetti A: Vasodilation to acetylcholine in primary and secondary forms of human hypertension. Hypertension 1993, 21:929–933.

    PubMed  CAS  Google Scholar 

  17. Ikeda U, Kanbe T, Nakayama I, et al.: Aldosterone inhibits nitric oxide synthesis in rat vascular smooth muscle cells induced by interleukin-1b. Eur J Pharmacol 1995, 290:69–73.

    Article  PubMed  CAS  Google Scholar 

  18. Farquiharson CAJ, Struthers AD: Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure. Circulation 2000, 101:594–597. Provides novel mechanisms of how spironolactone improves endothelial dysfunction, increases nitric oxide bioactivity, and inhibits angiotensin I/angiotensin II conversion at the vascular level.

    Google Scholar 

  19. Weber KT, Anversa, Armstrong PW, et al.: Remodeling and reparation of the cardiovascular system. J Am Coll Cardiol 1992, 20:3–16.

    Article  PubMed  CAS  Google Scholar 

  20. Lombes M, Oblin ME, Gasc JM, et al.: Immunohistochemical and biochemical evidence for a cardiovascular mineralocorticoid receptor. Circ Res 1992, 71:503–510.

    PubMed  CAS  Google Scholar 

  21. Benetos A, Lacolley P, Safar ME: Prevention of aortic fibrosis by spironolactone in spontaneously hypertensive rats. Arterioscler Thromb Vasc Biol 1997, 17:1152–1156.

    PubMed  CAS  Google Scholar 

  22. MacFadyen RJ, Barr CS, Struthers AD: Aldosterone blockade reduces vascular collagen turnover, improves heart rate variability and reduces early morning rise in heart rate in heart failure patients. Cardiovasc Res 1997, 35:30–34.

    Article  PubMed  CAS  Google Scholar 

  23. Sun Y, Ramires FJA, Weber KT: Fibrosis of atria and great vessels in response to angiotensin II or aldosterone infusion. Cardiovasc Res 1997, 35:138–147.

    Article  PubMed  CAS  Google Scholar 

  24. Rossier BC: Mechanisms of action of mineralocorticoid hormones. Endocr Res 1989, 15:206–226.

    Article  Google Scholar 

  25. Wehling M: Non-genomic actions of steroid hormones. Trends Endocrinol Metab 1994, 5:347–353.

    Article  CAS  PubMed  Google Scholar 

  26. Wehling M, Spes CH, Win N, et al.: Rapid cardiovascular action of aldosterone in man. J Clin Endocrinol Metab 1998, 83:3517–3522. Provides evidence for a rapid nongenomic action of aldosterone in humans.

    Article  PubMed  CAS  Google Scholar 

  27. Christ M, Douwes K, Eisen C, et al.: Rapid non-genomic effects of aldosterone on sodium transport in rat vascular smooth muscle cells: involvement of the Na+/H+ antiport. Hypertension 1995, 25:117–123.

    PubMed  CAS  Google Scholar 

  28. Wehling M, Neylon CB, Fullerton M, et al.: Non-genomic effects of aldosterone on intracellular calcium in vascular smooth muscle cells. Circ Res 1995, 76:973–979.

    PubMed  CAS  Google Scholar 

  29. Wehling M: Looking beyond the dogma of genomic steroid action: insights and facts of the 1990s. J Mol Med 1995, 73:439–447.

    Article  PubMed  CAS  Google Scholar 

  30. Ebata S, Muto S, Okada K, et al.: Aldosterone activates Na+/H+ exchange in vascular smooth muscle cells by non-genomic and genomic mechanisms. Kidney Int 1999, 56:1400–1412. Provides evidence that both genomic and nongenomic mechanisms regulate the aldosterone-induced activation of the Na+/H+ exchange in the vascular smooth muscle.

    Article  PubMed  CAS  Google Scholar 

  31. Schneider M, Ulsenheimer A, Christ M, Wehling M: Non-genomic effects of aldosterone on intracellular calcium in porcine endothelial cells. Am J Physiol 1997, 272:E616-E620.

    PubMed  CAS  Google Scholar 

  32. Hatakeyama H, Miyamori I, Fujita T, et al.: Vascular aldosterone. J Biol Chem 1994, 269:24316–24320.

    PubMed  CAS  Google Scholar 

  33. Takeda R, Hatakeyama H, Takeda Y, et al.: Aldosterone biosynthesis and action in vascular cells. Steroids 1995, 60:120–124.

    Article  PubMed  CAS  Google Scholar 

  34. Takeda Y, Miyamori I, Yoneda T, et al.: Regulation of aldosterone synthase in human vascular endothelial cells by angiotensin II and adrenocorticotropin. J Clin Endocrinol Metab 1996, 81:2797–2800.

    Article  PubMed  CAS  Google Scholar 

  35. Van Belle E, Bauters C, Wernert N, et al.: Neointimal thickening after balloon denudation is enhanced by aldosterone and inhibited by spironolactone, an aldosterone antagonist. Cardiovasc Res 1995, 29:27–32.

    Article  PubMed  CAS  Google Scholar 

  36. Rocha R, Chander PN, Khanna K, et al.: Mineralocorticoid blockade reduces vascular injury in stroke-prone hypertensive rats. Hypertension 1998, 31(suppl 1):451–458.

    PubMed  CAS  Google Scholar 

  37. Rocha R, Chander PN, Zuckerman A, Stier CT Jr: Role of aldosterone in renal vascular injury in stroke-prone hypertensive rats. Hypertension 1999, 33:232–237.

    PubMed  CAS  Google Scholar 

  38. Blacher J, Amah G, Girerd X, et al.: Association between increased plasma levels of aldosterone and decreased systemic arterial compliance in subjects with essential hypertension. Am J Hypertens 1997, 10:1326–1334.

    Article  PubMed  CAS  Google Scholar 

  39. Duprez DA, De Buyzere M, De Backer T, et al.: Influence of the arterial blood pressure and nonhemodynamic factors on the brachial artery pulsatility index in mild-to-moderate essential hypertension. Am J Cardiol 1993, 71:350–353.

    Article  PubMed  CAS  Google Scholar 

  40. Duprez DA, De Buyzere ML, Rietzschel ER, et al.: Inverse relationship between aldosterone and large artery compliance in chronically treated heart failure patients. Eur Heart J 1998, 19:1371–1376.

    Article  PubMed  CAS  Google Scholar 

  41. Rizzoni D, Porteri E, Castellano M, et al.: Vascular hypertrophy and remodeling in secondary hypertension. Hypertension 1996, 28:785–790.

    PubMed  CAS  Google Scholar 

  42. Clement DL: Effect of spironolactone on systemic blood pressure, limb blood flow and response to sympathetic stimulation in hypertensive patients. Eur J Clin Pharmacol 1988, 21:263–267.

    Article  Google Scholar 

  43. Schohn DC, Jahn HA, Pelletier BC: Dose-related cardiovascular effects of spironolactone. Am J Cardiol 1993, 71:40A-45A.

    Article  PubMed  CAS  Google Scholar 

  44. Rietzschel ER, Duprez DA, De Buyzere ML, Clement DL: Inverse relationship between aldosterone and venous capacitance in chronically treated congestive heart failure. Am J Cardiol 2000, 85:in press (issue 15 April).

  45. Wang W, McChain J, Zucker I: Aldosterone reduces baroreceptor discharge in the dog. Hypertension 1992, 19:270–277.

    PubMed  CAS  Google Scholar 

  46. Wang W: Chronic administration of aldosterone depresses baroreceptor reflex function in the dog. Hypertension 1994, 24:571–575.

    PubMed  CAS  Google Scholar 

  47. Yee KM, Struthers AD: Aldosterone blunts the baroreflex response in man. Clin Science 1998, 95:687–692.

    Article  CAS  Google Scholar 

  48. Veglio F, Molino P, CatGenova G, et al.: Impaired baroreflex function and arterial compliance in primary aldosteronism. J Hum Hypertens 1999, 13:29–36.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology and Angiology, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium

    Daniel Duprez MD, DSc, PhD, Marc De Buyzere BSc, Ernst R. Rietzschel MD & Denis L. Clement MD, PhD

Authors
  1. Daniel Duprez MD, DSc, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marc De Buyzere BSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ernst R. Rietzschel MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Denis L. Clement MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Duprez, D., De Buyzere, M., Rietzschel, E.R. et al. Aldosterone and vascular damage. Current Science Inc 2, 327–334 (2000). https://doi.org/10.1007/s11906-000-0017-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11906-000-0017-z

Keywords

Search

Navigation