This Article Full Text Full Text (PDF) All Versions of this Article: 52/2/207    most recent HYPERTENSIONAHA.108.111211v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Ruilope, L. M. Search for Related Content PubMed PubMed Citation Articles by Ruilope, L. M. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Kidney Diseases Related Collections Congestive Secondary prevention Clinical Studies Epidemiology Related Article

(Hypertension. 2008;52:207.)
© 2008 American Heart Association, Inc.

Editorial Commentaries

Aldosterone, Hypertension, and Cardiovascular Disease

An Endless Story

Luís M. Ruilope

From the Hypertension Unit, Hospital 12 de Octubre, Madrid, Spain.

Correspondence to Luís M. Ruilope, Unidad de Hipertensión, Hospital 12 de Octubre, Avda Cordoba s/n, 28041 Madrid, Spain. E-mail ruilope@ad-hocbox.com

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

A growing body of evidence has related the existence of an excess of aldosterone and the development and progression of cardiovascular (CV) and renal disease. The list of processes where the mineralocorticoid is involved in an independent manner includes arterial hypertension, congestive heart failure, chronic kidney disease, coronary artery disease, and stroke.¹

The association with aldosterone is particularly strong for arterial hypertension. The initial description by Conn² of primary aldosteronism proved the existence of a direct relationship between elevated levels of aldosterone and the development of hypertension. Such an association was initially considered a rare cause of secondary hypertension, with a prevalence <1%. However, recent data indicate the possible existence of an unrecognized epidemic of primary aldosteronism. In fact, a prospective study by Rossi et al³ investigated a group of 1125 patients and, through a carefully performed protocol, concluded that 11.2% presented with a primary hyperaldosteronism. Primary aldosteronism implies excessive organ damage to the heart, vessels, and kidney, which facilitates a higher frequency of CV events,⁴ and if its real prevalence is higher than reported previously, its contribution to the final consequences of CV and renal disease in the hypertensive population could be very relevant.

The contribution of aldosterone to the development of arterial hypertension in the general population has been shown recently by the Framingham Offspring Study in which serum plasma aldosterone levels in normotensive subjects predicted subsequent increases in blood pressure and in the development of incident hypertension.⁵ A role of aldosterone in arterial hypertension is also suggested . . . [Full Text of this Article]

Related Article:

History of Hypertension and Eplerenone in Patients With Acute Myocardial Infarction Complicated by Heart Failure

Bertram Pitt, Ali Ahmed, Thomas E. Love, Henry Krum, Jose Nicolau, José S. Cardoso, Alexander Parkhomenko, Michael Aschermann, Ramon Corbalán, Henry Solomon, Harry Shi, and Faiez Zannad
Hypertension 2008 52: 271-278. [Abstract] [Full Text] [PDF]