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Aldosterone Synthase Inhibition in Hypertension

  • Hypertension Management and Antihypertensive Drugs (HM Siragy and B Waeber, Section Editors)
  • Published:
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Abstract

Hypertension is an established risk factor for stroke, premature coronary artery disease and heart failure. Control of elevated blood pressure has been shown to result in significant reduction of cardiovascular risk. Aldosterone, the final product of the renin–angiotensin–aldosterone system (RAAS), not only causes salt and water reabsorbtion in the kidneys through its effect on the mineralocorticoid hormone receptor (MR), but also an MR-independent effect, not regulated by conventional MR blockade. Although many pharmacological agents target different levels of the RAAS cascade, these generally result in elevated renin concentration and plasma renin activity. This upstream feedback response subsequently results in elevated levels of angiotensin II, a potent vasoconstrictor and stimulus to aldosterone release. This aldosterone breakthrough counteracts the long-term blood pressure–lowering effect of these agents. Therefore the development of a new class of pharmacologic agents that directly inhibit the production of aldosterone may prove clinically useful in reducing aldosterone and thereby controlling elevated blood pressure.

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Karl Andersen declares that he has no conflict of interest.

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

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  1. Cardiovascular Research Center, Landspitali the University Hospital of Iceland, IS-101, Reykjavik, Iceland

    Karl Andersen

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Andersen, K. Aldosterone Synthase Inhibition in Hypertension. Curr Hypertens Rep 15, 484–488 (2013). https://doi.org/10.1007/s11906-013-0379-7

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