IMR Press / RCM / Volume 5 / Issue 2 / pii/1561344968783-1724307444

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
The Role of Aldosterone and Aldosterone-Receptor Antagonists in Heart Failure
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1 Brody School of Medicine, East Carolina University, Greenville, NC
Rev. Cardiovasc. Med. 2004, 5(2), 71–81;
Published: 30 June 2004
Abstract
Prolonged overactivation of neurohormonal mechanisms in heart failure produces deleterious effects on the cardiovascular system and leads to poor prognosis. Angiotensinconverting enzyme (ACE) inhibitors and ß-blockers have been shown to interrupt this excessive overactivity and improve survival. Activation of the renin-angiotensin system leads to increased synthesis of aldosterone in heart failure. Some aldosterone production is independent of ACEs; therefore, ACE inhibition does not entirely suppress the excessive formation of aldosterone. An excess of aldosterone in heart failure leads to sodium retention and myocardial fibrosis. The use of aldosterone antagonists, combined with standard therapy for heart failure, improves morbidity and mortality.
Keywords
Congestive heart failure
Aldosterone
Aldosterone-receptor antagonist
Spironolactone
Eplerenone
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