Current Hypertension Reports

, Volume 15, Issue 2, pp 102–107

Aldosterone and the Risk of Hypertension

Pathogenesis of Hypertension (R Agarwal, Section Editor)


Aldosterone, the key hormone in the mineralocorticoid pathway, plays a fundamental role in salt and water homeostasis, blood pressure regulation, and cardiovascular remodeling. Both genomic and nongenomic mechanisms influence aldosterone-induced renal sodium reabsorption. Furthermore, the mineralocorticoid receptors in nonepithelial tissues, including the heart and vascular smooth muscle cells, have recently been discovered. Thus, aldosterone likely has pleiotropic effects that contribute to the modulation of blood pressure. Among patients with hypertension in general, and among those with more severe or resistant hypertension in particular, a higher-than-expected prevalence of primary hyperaldosteronism is noted. Among individuals with resistant hypertension, aldosterone antagonists have also been shown to be effective in lowering blood pressure. Most significantly, recent community-based studies among non-hypertensive individuals in the general population have demonstrated that both higher serum aldosterone concentrations and a higher aldosterone to renin ratio portend a greater risk of developing hypertension. The combination of the aforementioned observations underscores the importance of the mineralocorticoid pathway in the pathogenesis of hypertension.


Aldosterone Mineralocorticoid receptor Aldosterone to renin ratio ARR Primary hyperaldosteronism Natriuretic peptides Salt sensitivity Blood pressure Hypertension Cardiovascular disease Risk 


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Vanessa Xanthakis
    • 1
    • 2
    • 3
    • 4
  • Ramachandran S. Vasan
    • 1
    • 3
    • 4
  1. 1.Section of Preventive Medicine and EpidemiologyBoston University School of MedicineBostonUSA
  2. 2.BiostatisticsBoston University School of Public HealthBostonUSA
  3. 3.Department of MedicineBoston University School of MedicineBostonUSA
  4. 4.Framingham Heart StudyFraminghamUSA

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