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(Hypertension. 2008;51:1252.)
© 2008 American Heart Association, Inc.

Brief Reviews

Aldosterone and Metabolic Syndrome

Is Increased Aldosterone in Metabolic Syndrome Patients an Additional Risk Factor?

From the Carl Gustav Carus University Hospital, Medical Clinic III, University of Dresden, Dresden, Germany. Current address (A.W.K.): National Institute on Aging, Gerontology Research Center, National Institutes of Health, 5600 Nathan Shock Drive, Baltimore, MD 21224-6825.

Correspondence to Alexander W. Krug, University Hospital Carl Gustav Carus, Medical Clinic III, University of Dresden, Fetscherstraβe 74, 01307 Dresden, Germany. E-mail krugaw@mail.nih.gov

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The classic role of aldosterone is to regulate water and electrolyte balance and, therefore, blood pressure homeostasis.¹ Apart from that, experimental studies have demonstrated that aldosterone induces structural and functional alterations in the heart, kidneys, and vessels with effects such as myocardial fibrosis, nephrosclerosis, vascular inflammation and remodeling, and disturbed fibrinolysis.^2,3 This damage seems to be aldosterone mediated, and aldosterone blockade with mineralocorticoid receptor (MR) antagonists, such as spironolactone, may prevent the onset of these effects.^4,5 On the other hand, it cannot completely be ruled out that potassium and high blood pressure also play additional key roles in this damage.^6,7 This evidence has impressively been supported by clinical studies, such as the Randomized Aldactone Evaluation Study and the Eplerenone Post-Acute Myocardial Infarction Survival and Efficacy Study.^8,9 For example, increased mortality in patients with chronic heart failure has been associated with elevated aldosterone plasma levels,¹⁰ and high circulating plasma aldosterone levels predict the clinical outcome in patients after myocardial infarction.¹¹ Furthermore, primary aldosteronism (PA) has been demonstrated to enhance the risk of cardiovascular events¹² and kidney disease.¹³ In summary, aldosterone is considered a cardiovascular risk factor, promoting disease processes such as cardiac fibrosis, nephrosclerosis, and arteriosclerosis,^2,3,14 all of which are increased in patients with obesity and the metabolic syndrome.^15,16

	What Role Does Aldosterone Play in the Metabolic Syndrome?

 
The term "metabolic syndrome" (MSyn) has evolved various definitions in recent times; most of the studies introduced here use slight modifications. Nevertheless, all of the definitions used have a common denominator, which is reflected in a definition by the American Heart Association/National . . . [Full Text of this Article]

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