1. The role of aldosterone in cardiovascular disease in people with diabetes and hypertension: an update
- Author
-
James R. Sowers, Guido Lastra-Gonzalez, and Camila Manrique-Acevedo
- Subjects
medicine.medical_specialty ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Diabetes Complications ,Renin-Angiotensin System ,chemistry.chemical_compound ,Mineralocorticoid receptor ,Insulin resistance ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,Medicine ,Glucose homeostasis ,Humans ,Aldosterone ,business.industry ,Type 2 Diabetes Mellitus ,medicine.disease ,Endocrinology ,chemistry ,Mineralocorticoid ,Cardiovascular Diseases ,Hypertension ,Insulin Resistance ,business ,Kidney disease - Abstract
The role of mineralocorticoids in the development of cardiovascular disease (CVD), cardiometabolic syndrome, type 2 diabetes mellitus, chronic kidney disease (CKD), and hypertension is a growing field of interest. Aldosterone, mainly through nongenomic actions that result in proliferation, fibrosis, inflammation, and tissue remodeling, has been linked to CVD and CKD. Increased circulating aldosterone is also associated with insulin resistance and impaired glucose homeostasis that contribute to the development of endothelial dysfunction, atherosclerosis, and kidney disease. Aldosterone-induced oxidative stress and inflammation play a key role in impairing insulin signaling. Mineralocorticoid receptor blockade restores insulin sensitivity, counterbalances the deleterious cardiovascular and renal effects of aldosterone, and emerges as an alternative to improve blockade of the renin-angiotensin-aldosterone system, which potentially could contribute to reduce the burden of CVD and CKD.
- Published
- 2008