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Previous Volume 345:1689-1697 December 6, 2001 Number 23 Next

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Aldosterone was isolated from blood and urine, its adrenal origin elucidated, and its steroid structure identified nearly 50 years ago. Actions involving the reabsorption of sodium and the release of potassium by epithelial cells in the kidneys, intestine, and sweat and salivary glands led to its designation as a mineralocorticoid. The physiologic importance of aldosterone in preventing the loss of salt and water during periods of dietary sodium deprivation is now clear. Its contribution to the retention of sodium in patients with congestive heart failure, cirrhosis, and the nephrotic syndrome has also been established.^1,2,3 The perception of its pathophysiologic importance . . . [Full Text of this Article]

The Renin–Angiotensin–Aldosterone System

Aldosterone and the Pathophysiology of Congestive Heart Failure

Congestive Heart Failure: A Salt-Avid Syndrome

Conclusions

Source Information

From the Division of Cardiovascular Diseases, Department of Medicine, University of Tennessee Health Science Center, Rm. 353 Dobbs Research Institute, 951 Court Ave., Memphis, TN 38163, where reprint requests should be addressed to Dr. Weber.

References

This article has been cited by other articles:

• Massie, B. M., Carson, P. E., McMurray, J. J., Komajda, M., McKelvie, R., Zile, M. R., Anderson, S., Donovan, M., Iverson, E., Staiger, C., Ptaszynska, A., the I-PRESERVE Investigators, (2008). Irbesartan in Patients with Heart Failure and Preserved Ejection Fraction. NEJM 0: NEJMoa0805450v1-1 [Abstract] [Full Text]  
• van Diepen, S., Majumdar, S. R., Bakal, J. A., McAlister, F. A., Ezekowitz, J. A. (2008). Heart Failure Is a Risk Factor for Orthopedic Fracture: A Population-Based Analysis of 16 294 Patients. Circulation 118: 1946-1952 [Abstract] [Full Text]  
• Pitt, B. (2008). The measurement of plasma aldosterone in patients post-myocardial infarction. Eur Heart J 29: 2451-2452 [Full Text]  
• Albert, N. M. (2008). Improving Medication Adherence in Chronic Cardiovascular Disease. Crit Care Nurse 28: 54-64 [Full Text]  
• Carbone, L. D., Cross, J. D., Raza, S. H., Bush, A. J., Sepanski, R. J., Dhawan, S., Khan, B. Q., Gupta, M., Ahmad, K., Khouzam, R. N., Dishmon, D. A., Nesheiwat, J. P., Hajjar, M. A., Chishti, W. A., Nasser, W., Khan, M., Womack, C. R., Cho, T., Haskin, A. R., Weber, K. T. (2008). Fracture Risk in Men With Congestive Heart Failure: Risk Reduction With Spironolactone. J Am Coll Cardiol 52: 135-138 [Abstract] [Full Text]  
• Huang, W., Xu, C., Kahng, K. W., Noble, N. A., Border, W. A., Huang, Y. (2008). Aldosterone and TGF-{beta}1 synergistically increase PAI-1 and decrease matrix degradation in rat renal mesangial and fibroblast cells. Am. J. Physiol. Renal Physiol. 294: F1287-F1295 [Abstract] [Full Text]  
• Haddad, F., Doyle, R., Murphy, D. J., Hunt, S. A. (2008). Right Ventricular Function in Cardiovascular Disease, Part II: Pathophysiology, Clinical Importance, and Management of Right Ventricular Failure. Circulation 117: 1717-1731 [Full Text]  
• Swaminathan, K., Davies, J., Struthers, A. (2008). Review: Aldosterone antagonism in type 2 diabetes mellitus -- a new therapeutic approach to diabetic macrovascular disease?. British Journal of Diabetes & Vascular Disease 8: 16-19 [Abstract]  
• Vittorio, T. J, Ahuja, K., Kasper, M., Turalic, H., Tseng, C.-H., Jorde, U. P, Gor, C. (2007). Comparison of high- versus low-tissue affinity ACE-inhibitor treatment on circulating aldosterone levels in patients with chronic heart failure. Journal of Renin-Angiotensin-Aldosterone System 8: 200-204 [Abstract]  
• Alsafwah, S., LaGuardia, S. P., Arroyo, M., Dockery, B. K., Bhattacharya, S. K., Ahokas, R. A., Newman, K. P. (2007). Congestive Heart Failure is a Systemic Illness: A Role for Minerals and Micronutrients. Clin Med Res 5: 238-243 [Abstract] [Full Text]  
• Ambroisine, M.-L., Favre, J., Oliviero, P., Rodriguez, C., Gao, J., Thuillez, C., Samuel, J.-L., Richard, V., Delcayre, C. (2007). Aldosterone-Induced Coronary Dysfunction in Transgenic Mice Involves the Calcium-Activated Potassium (BKCa) Channels of Vascular Smooth Muscle Cells. Circulation 116: 2435-2443 [Abstract] [Full Text]  
• Thomas, M., Vidal, A., Bhattacharya, S. K., Ahokas, R. A., Sun, Y., Gerling, I. C., Weber, K. T. (2007). Zinc dyshomeostasis in rats with aldosteronism. Response to spironolactone. Am. J. Physiol. Heart Circ. Physiol. 293: H2361-H2366 [Abstract] [Full Text]  
• Cohn, J. N. (2007). Myocardial Structural Effects of Aldosterone Receptor Antagonism in Heart Failure. J Am Coll Cardiol 50: 597-599 [Full Text]  
• Pitt, B., Pitt, G. S. (2007). Added Benefit of Mineralocorticoid Receptor Blockade in the Primary Prevention of Sudden Cardiac Death. Circulation 115: 2976-2982 [Full Text]  
• Cazzaniga, M., Salerno, F., Pagnozzi, G., Dionigi, E., Visentin, S., Cirello, I., Meregaglia, D., Nicolini, A. (2007). Diastolic dysfunction is associated with poor survival in patients with cirrhosis with transjugular intrahepatic portosystemic shunt. Gut 56: 869-875 [Abstract] [Full Text]  
• Guder, G., Bauersachs, J., Frantz, S., Weismann, D., Allolio, B., Ertl, G., Angermann, C. E., Stork, S. (2007). Complementary and Incremental Mortality Risk Prediction by Cortisol and Aldosterone in Chronic Heart Failure. Circulation 115: 1754-1761 [Abstract] [Full Text]  
• Groban, L., Butterworth, J. (2006). Perioperative management of chronic heart failure.. Anesth. Analg. 103: 557-575 [Abstract] [Full Text]  
• Kane, G. C., Behfar, A., Dyer, R. B., O'Cochlain, D. F., Liu, X.-K., Hodgson, D. M., Reyes, S., Miki, T., Seino, S., Terzic, A. (2006). KCNJ11 gene knockout of the Kir6.2 KATP channel causes maladaptive remodeling and heart failure in hypertension. Hum Mol Genet 15: 2285-2297 [Abstract] [Full Text]  
• Sun, Y., Ahokas, R. A., Bhattacharya, S. K., Gerling, I. C., Carbone, L. D., Weber, K. T. (2006). Oxidative stress in aldosteronism. Cardiovasc Res 71: 300-309 [Abstract] [Full Text]  
• Nagata, D., Takahashi, M., Sawai, K., Tagami, T., Usui, T., Shimatsu, A., Hirata, Y., Naruse, M. (2006). Molecular Mechanism of the Inhibitory Effect of Aldosterone on Endothelial NO Synthase Activity. Hypertension 48: 165-171 [Abstract] [Full Text]  
• Ahmed, A., Husain, A., Love, T. E., Gambassi, G., Dell'Italia, L. J., Francis, G. S., Gheorghiade, M., Allman, R. M., Meleth, S., Bourge, R. C. (2006). Heart failure, chronic diuretic use, and increase in mortality and hospitalization: an observational study using propensity score methods. Eur Heart J 27: 1431-1439 [Abstract] [Full Text]  
• Grobe, J. L., Mecca, A. P., Mao, H., Katovich, M. J. (2006). Chronic angiotensin-(1-7) prevents cardiac fibrosis in DOCA-salt model of hypertension. Am. J. Physiol. Heart Circ. Physiol. 290: H2417-H2423 [Abstract] [Full Text]  
• Buss, S. J., Backs, J., Kreusser, M. M., Hardt, S. E., Maser-Gluth, C., Katus, H. A., Haass, M. (2006). Spironolactone Preserves Cardiac Norepinephrine Reuptake in Salt-Sensitive Dahl Rats. Endocrinology 147: 2526-2534 [Abstract] [Full Text]  
• Covic, A., Gusbeth-Tatomir, P., Goldsmith, D. J. A. (2006). Is it time for spironolactone therapy in dialysis patients?. Nephrol Dial Transplant 21: 854-858 [Full Text]  
• Anand, K., Mooss, A. N, Mohiuddin, S. M (2006). Review: Aldosterone Inhibition Reduces the Risk of Sudden Cardiac Death in Patients with Heart Failure. Journal of Renin-Angiotensin-Aldosterone System 7: 15-19 [Abstract]  
• Schrier, R. W. (2006). Role of Diminished Renal Function in Cardiovascular Mortality: Marker or Pathogenetic Factor?. J Am Coll Cardiol 47: 1-8 [Abstract] [Full Text]  
• Marcy, T. R., Ripley, T. L. (2006). Aldosterone antagonists in the treatment of heart failure. Am J Health Syst Pharm 63: 49-58 [Abstract] [Full Text]  
• Leri, A., Kajstura, J., Anversa, P. (2005). Cardiac Stem Cells and Mechanisms of Myocardial Regeneration. Physiol. Rev. 85: 1373-1416 [Abstract] [Full Text]  
• Quinkler, M., Zehnder, D., Eardley, K. S., Lepenies, J., Howie, A. J., Hughes, S. V., Cockwell, P., Hewison, M., Stewart, P. M. (2005). Increased Expression of Mineralocorticoid Effector Mechanisms in Kidney Biopsies of Patients With Heavy Proteinuria. Circulation 112: 1435-1443 [Abstract] [Full Text]  
• Williams, G. H. (2005). Cardiovascular Benefits of Aldosterone Receptor Antagonists: What About Potassium?. Hypertension 46: 265-266 [Full Text]  
• Davis, M. P., Albert, N. M., Young, J. B. (2005). Palliation of heart failure. AM J HOSP PALLIAT CARE 22: 211-222 [Abstract]  
• Chhokar, V. S., Sun, Y., Bhattacharya, S. K., Ahokas, R. A., Myers, L. K., Xing, Z., Smith, R. A., Gerling, I. C., Weber, K. T. (2005). Hyperparathyroidism and the Calcium Paradox of Aldosteronism. Circulation 111: 871-878 [Abstract] [Full Text]  
• Yan, A. T., Yan, R. T., Liu, P. P. (2005). Narrative Review: Pharmacotherapy for Chronic Heart Failure: Evidence from Recent Clinical Trials. ANN INTERN MED 142: 132-145 [Abstract] [Full Text]  
• Barnes, B. J, Howard, P. A (2005). Eplerenone: A Selective Aldosterone Receptor Antagonist for Patients with Heart Failure. The Annals of Pharmacotherapy 39: 68-76 [Abstract] [Full Text]  
• Funabiki, K., Onishi, K., Dohi, K., Koji, T., Imanaka-Yoshida, K., Ito, M., Wada, H., Isaka, N., Nobori, T., Nakano, T. (2004). Combined angiotensin receptor blocker and ACE inhibitor on myocardial fibrosis and left ventricular stiffness in dogs with heart failure. Am. J. Physiol. Heart Circ. Physiol. 287: H2487-H2492 [Abstract] [Full Text]  
• Chhokar, V. S., Sun, Y., Bhattacharya, S. K., Ahokas, R. A., Myers, L. K., Xing, Z., Smith, R. A., Gerling, I. C., Weber, K. T. (2004). Loss of bone minerals and strength in rats with aldosteronism. Am. J. Physiol. Heart Circ. Physiol. 287: H2023-H2026 [Abstract] [Full Text]  
• Garnier, A., Bendall, J. K., Fuchs, S., Escoubet, B., Rochais, F., Hoerter, J., Nehme, J., Ambroisine, M.-L., De Angelis, N., Morineau, G., d'Estienne, P., Fischmeister, R., Heymes, C., Pinet, F., Delcayre, C. (2004). Cardiac Specific Increase in Aldosterone Production Induces Coronary Dysfunction in Aldosterone Synthase-Transgenic Mice. Circulation 110: 1819-1825 [Abstract] [Full Text]  
• McCurley, J. M., Hanlon, S. U., Wei, S.-k., Wedam, E. F., Michalski, M., Haigney, M. C. (2004). Furosemide and the progression of left ventricular dysfunction in experimental heart failure. J Am Coll Cardiol 44: 1301-1307 [Abstract] [Full Text]  
• Weber, K. T. (2004). Furosemide in the long-term management of heart failure: The good, the bad, and the uncertain. J Am Coll Cardiol 44: 1308-1310 [Full Text]  
• Lim, H. S., MacFadyen, R. J., Lip, G. Y. H. (2004). Diabetes Mellitus, the Renin-Angiotensin-Aldosterone System, and the Heart. Arch Intern Med 164: 1737-1748 [Abstract] [Full Text]  
• Ng, M K C, Celermajer, D S (2004). Glucocorticoid treatment and cardiovascular disease. Heart 90: 829-830 [Abstract] [Full Text]  
• Francis, J., Chu, Y., Johnson, A. K., Weiss, R. M., Felder, R. B. (2004). Acute myocardial infarction induces hypothalamic cytokine synthesis. Am. J. Physiol. Heart Circ. Physiol. 286: H2264-H2271 [Abstract] [Full Text]  
• Juknevicius, I., Segal, Y., Kren, S., Lee, R., Hostetter, T. H. (2004). Effect of aldosterone on renal transforming growth factor-{beta}. Am. J. Physiol. Renal Physiol. 286: F1059-F1062 [Abstract] [Full Text]  
• Wang, Q., Clement, S., Gabbiani, G., Horisberger, J.-D., Burnier, M., Rossier, B. C., Hummler, E. (2004). Chronic hyperaldosteronism in a transgenic mouse model fails to induce cardiac remodeling and fibrosis under a normal-salt diet. Am. J. Physiol. Renal Physiol. 286: F1178-F1184 [Abstract] [Full Text]  
• Shieh, F. K, Kotlyar, E., Sam, F. (2004). Aldosterone and cardiovascular remodelling: focus on myocardial failure. Journal of Renin-Angiotensin-Aldosterone System 5: 3-13 [Abstract]  
• Metra, M., Nodari, S., Dei Cas, L. (2004). Current guidelines in the pharmacological management of chronic heart failure. Journal of Renin-Angiotensin-Aldosterone System 5: S11-S16 [Abstract]  
• Struthers, A. D (2004). Aldosterone blockade in heart failure. Journal of Renin-Angiotensin-Aldosterone System 5: S23-S27 [Abstract]  
• Latini, R., Masson, S., Anand, I., Salio, M., Hester, A., Judd, D., Barlera, S., Maggioni, A. P, Tognoni, G., Cohn, J. N, for the Val-HeFT Investigators, (2004). The comparative prognostic value of plasma neurohormones at baseline in patients with heart failure enrolled in Val-HeFT. Eur Heart J 25: 292-299 [Abstract] [Full Text]  
• Goodfriend, T. L., Ball, D. L., Egan, B. M., Campbell, W. B., Nithipatikom, K. (2004). Epoxy-Keto Derivative of Linoleic Acid Stimulates Aldosterone Secretion. Hypertension 43: 358-363 [Abstract] [Full Text]  
• McFarlane, S. I., Winer, N., Sowers, J. R. (2003). Role of the Natriuretic Peptide System in Cardiorenal Protection. Arch Intern Med 163: 2696-2704 [Abstract] [Full Text]  
• Fraccarollo, D., Galuppo, P., Hildemann, S., Christ, M., Ertl, G., Bauersachs, J. (2003). Additive improvement of left ventricular remodeling and neurohormonal activation by aldosterone receptor blockade with eplerenone and ACE inhibition in rats with myocardial infarction. J Am Coll Cardiol 42: 1666-1673 [Abstract] [Full Text]  
• Pitt, B. (2003). Aldosterone Blockade in Patients With Systolic Left Ventricular Dysfunction. Circulation 108: 1790-1794 [Full Text]  
• Cohn, J. N., Anand, I. S., Latini, R., Masson, S., Chiang, Y.-T., Glazer, R. (2003). Sustained Reduction of Aldosterone in Response to the Angiotensin Receptor Blocker Valsartan in Patients With Chronic Heart Failure: Results From the Valsartan Heart Failure Trial. Circulation 108: 1306-1309 [Abstract] [Full Text]  
• Chee, K. H, Amudha, K., Hussain, N. A, Haizal, H. K, Choy, A.-M. J, Lang, C. C (2003). Combination of drugs acting on the natriuretic system and the renin-angiotensin system in heart failure. Journal of Renin-Angiotensin-Aldosterone System 4: 140-148 [Abstract]  
• Weber, K. T, Yao Sun, , Wodi, L. A, Munir, A., Jahangir, E., Ahokas, R. A, Gerling, I. C, Postlethwaite, A. E, Warrington, K. J (2003). Toward a broader understanding of aldosterone in congestive heart failure. Journal of Renin-Angiotensin-Aldosterone System 4: 155-163 [Abstract]  
• Hostetter, T. H., Ibrahim, H. N. (2003). Aldosterone in Chronic Kidney and Cardiac Disease. J. Am. Soc. Nephrol. 14: 2395-2401 [Abstract] [Full Text]  
• Young, M., Funder, J. (2003). Mineralocorticoid Action and Sodium-Hydrogen Exchange: Studies in Experimental Cardiac Fibrosis. Endocrinology 144: 3848-3851 [Abstract] [Full Text]  
• Hernandez, A. F., O'Connor, C. M. (2003). Sparing a little may save a lot: Lessons from the Studies of Left Ventricular Dysfunction (SOLVD). J Am Coll Cardiol 42: 709-711 [Full Text]  
• Gambaryan, S., Butt, E., Marcus, K., Glazova, M., Palmetshofer, A., Guillon, G., Smolenski, A. (2003). cGMP-dependent Protein Kinase Type II Regulates Basal Level of Aldosterone Production by Zona Glomerulosa Cells without Increasing Expression of the Steroidogenic Acute Regulatory Protein Gene. J. Biol. Chem. 278: 29640-29648 [Abstract] [Full Text]  
• Andrew, P. (2003). Diastolic Heart Failure Demystified. Chest 124: 744-753 [Abstract] [Full Text]  
• Hollenberg, N. K., Williams, G. H., Anderson, R., Akhras, K. S., Bittman, R. M., Krause, S. L. (2003). Symptoms and the Distress They Cause: Comparison of an Aldosterone Antagonist and a Calcium Channel Blocking Agent in Patients With Systolic Hypertension. Arch Intern Med 163: 1543-1548 [Abstract] [Full Text]  
• White, P. C. (2003). Aldosterone: Direct Effects on and Production by the Heart. J. Clin. Endocrinol. Metab. 88: 2376-2383 [Full Text]  
• Cittadini, A., Monti, M. G., Isgaard, J., Casaburi, C., Stromer, H., Di Gianni, A., Serpico, R., Saldamarco, L., Vanasia, M., Sacca, L. (2003). Aldosterone receptor blockade improves left ventricular remodeling and increases ventricular fibrillation threshold in experimental heart failure. Cardiovasc Res 58: 555-564 [Abstract] [Full Text]  
• Jessup, M., Brozena, S. (2003). Heart Failure. NEJM 348: 2007-2018 [Full Text]  
• Muller, O. G., Parnova, R. G., Centeno, G., Rossier, B. C., Firsov, D., Horisberger, J.-D. (2003). Mineralocorticoid Effects in the Kidney: Correlation between {alpha}ENaC, GILZ, and Sgk-1 mRNA Expression and Urinary Excretion of Na+ and K+. J. Am. Soc. Nephrol. 14: 1107-1115 [Abstract] [Full Text]  
• Jessup, M. (2003). Aldosterone Blockade and Heart Failure. NEJM 348: 1380-1382 [Full Text]  
• Ben-Yehuda, O. (2003). Hypertension, angiotensin II, aldosterone, and race. J Am Coll Cardiol 41: 1156-1158 [Full Text]  
• Zwieten, P.A. v. (2003). Drug Treatment of Congestive Heart Failure. SEMIN CARDIOTHORAC VASC ANESTH 7: 13-17 [Abstract]  
• Felder, R. B., Francis, J., Zhang, Z.-H., Wei, S.-G., Weiss, R. M., Johnson, A. K. (2003). Heart failure and the brain: new perspectives. Am. J. Physiol. Regul. Integr. Comp. Physiol. 284: R259-R276 [Abstract] [Full Text]  
• Hankey, G. J. (2003). Angiotensin-Converting Enzyme Inhibitors for Stroke Prevention: Is There HOPE for PROGRESS After LIFE?. Stroke 34: 354-356 [Full Text]  
• Manabe, I., Shindo, T., Nagai, R. (2002). Gene Expression in Fibroblasts and Fibrosis: Involvement in Cardiac Hypertrophy. Circ. Res. 91: 1103-1113 [Abstract] [Full Text]  
• Rousseau, M. F., Gurne, O., Duprez, D., Van Mieghem, W., Robert, A., Ahn, S., Galanti, L., Ketelslegers, J.-M., Belgian RALES Investigators, (2002). Beneficial neurohormonal profile of spironolactone in severe congestive heart failure: Results from the RALES neurohormonal substudy. J Am Coll Cardiol 40: 1596-1601 [Abstract] [Full Text]  
• Sun, Y., Zhang, J., Lu, L., Chen, S. S., Quinn, M. T., Weber, K. T. (2002). Aldosterone-Induced Inflammation in the Rat Heart : Role of Oxidative Stress. Am. J. Pathol. 161: 1773-1781 [Abstract] [Full Text]  
• Jorde, U. P., Vittorio, T., Katz, S. D., Colombo, P. C., Latif, F., Le Jemtel, T. H. (2002). Elevated Plasma Aldosterone Levels Despite Complete Inhibition of the Vascular Angiotensin-Converting Enzyme in Chronic Heart Failure. Circulation 106: 1055-1057 [Abstract] [Full Text]  
• Andrew, P. (2002). Renin-Angiotensin-Aldosterone Activation in Heart Failure, Aldosterone Escape. Chest 122: 755-755 [Full Text]