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Mineralocorticoids and Cardiovascular Disease in Females with Insulin Resistance and Obesity

  • Manav Nayyar
  • Guido Lastra
  • Camila Manrique Acevedo
Hypertension and Obesity (E Reisin, Section Editor)
  • 63 Downloads
Part of the following topical collections:
  1. Topical Collection on Hypertension and Obesity

Abstract

Purpose of the Review

In the present review, we will discuss the evidence and the mechanisms underlying the complex interplay between obesity, mineralocorticoid receptor activation, and cardiovascular dysfunction with special emphasis on the pathogenesis of cardiovascular disease (CVD) in obese and insulin-resistant females.

Recent Findings

Since the initial isolation of aldosterone in 1953 and the cloning of the mineralocorticoid receptor (MR) decades later, our understanding has expanded tremendously regarding their involvement in the pathogenesis of CVD. Recent results from both pre-clinical and clinical studies support a close correlation between increase adiposity and enhanced aldosterone production (MR activation).

Summary

Importantly, insulin resistance and obese females are more prone to the deleterious cardiovascular effects of MR activation, and enhanced MR activation in females has emerged as an important causative event in the genesis of a more severe CVD in diabetic women. Different clinical trials have been completed examining the effect of MR blockade in subjects with CVD. Despite its important beneficial mortality impact, side effects are frequent and a newer MR antagonist, finerenone, with less risk of hyperkalemia is currently being tested in large clinical trials.

Keywords

Obesity Females Cardiovascular disease Aldosterone Mineralocorticoid receptor 

Notes

Compliance with Ethics Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

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, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Manav Nayyar
    • 1
  • Guido Lastra
    • 1
    • 2
  • Camila Manrique Acevedo
    • 1
    • 2
  1. 1.Department of Medicine, Division of EndocrinologyUniversity of MissouriColumbiaUSA
  2. 2.Research Service Harry S. Truman Memorial Veterans HospitalColumbiaUSA

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