Session: S49-Inside and Out: Aldosterone Synthesis and Action
Room 304 (Moscone Center)
Clinical and basic studies demonstrate that aldosterone and its receptor, the mineralocorticoid receptor, are important factors in the development of vascular, cardiac and renal injury, independent of aldosterone’s well-known actions promoting volume expansion and hypertension. Mineralocorticoid receptor blockade reduces renal injury (albuminuria and glomerular injury) in rodent models of type 1 and type 2 diabetes mellitus, reduces adipose tissue inflammation and improves insulin sensitivity in rodent models of type 2 diabetes mellitus, and reduces vascular, renal and cardiac damage under experimental conditions of high angiotensin II and low nitric oxide. Recent evidence implicates a variety of novel proteins in regulation of mineralocorticoid receptor function, including rac1, striatin, caveolin-1 and lysine specific demethylase 1. In humans, addition of mineralocorticoid receptor blockade to angiotensin receptor blockade or angiotensin converting enzyme inhibitor therapy improves morbidity and mortality in heart failure and has beneficial effects on albuminuria and coronary microcirculatory function in type 2 diabetes mellitus.