Mineralocorticoid Receptor Antagonists and the Metabolic Syndrome
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.
KeywordsAldosterone Mineralocorticoid receptor Obesity Insulin resistance Spironolactone Eplerenone
This work is supported in part by a grant from the National Institutes of Health, R01HL 087060 (GKA and RG).
No potential conflicts of interest relevant to this article were reported.
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