This Article Extract Full Text (PDF) All Versions of this Article: 47/3/312    most recent 01.HYP.0000201443.63240.a7v1 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 HighWire Citing Articles via Google Scholar Google Scholar Articles by Schiffrin, E. L. Search for Related Content PubMed PubMed Citation Articles by Schiffrin, E. L. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Related Collections Remodeling Smooth muscle proliferation and differentiation Endothelium/vascular type/nitric oxide Other Vascular biology

(Hypertension. 2006;47:312.)
© 2006 American Heart Association, Inc.

Hypertension Highlights

Effects of Aldosterone on the Vasculature

From the Clinical Research Institute of Montreal, University of Montreal, Montreal, Quebec, Canada.

Correspondence to Ernesto L. Schiffrin, SMBD Jewish General Hospital and Lady Davis Institute of Medical Research, McGill University, 3755 Côte-Ste-Catherine Rd, Montreal, PQ, Canada H3T 1E2. E-mail ernesto.schiffrin{at}mcgill.ca

	Introduction

Top Introduction Endothelium Smooth Muscle Cells Integrative Molecular Physiology... Conclusions References

 
Aldosterone is a steroid with mineralocorticoid activity produced mostly by the adrenal glomerulosa. Aldosterone may also be generated in the heart and blood vessels, although there is controversy on whether the amounts produced are physiologically relevant. The classical target of aldosterone is the distal convoluted tubule of the kidney, where it acts on cytosolic mineralocorticoid receptors (MRs) that translocate to the nucleus and via different mechanisms (serum and glucocorticoid-induced kinase-1 [SGK-1], neural precursor cell expressed developmentally downregulated 4 [nedd4], nedd4 isoform 2 [nedd4-2], K-Ras2A, and capsaicin)¹ modulating the epithelial sodium channel and renal outer medullary potassium channels to induce increased reabsorption of sodium and excretion of potassium, thus regulating sodium, potassium, and body fluid balance.

Over the past few years it has become increasingly evident that aldosterone exerts powerful effects on blood vessels,² independent of actions that can be attributed to blood pressure (BP) rise mediated via regulation of salt and water balance. Some deleterious consequences of aldosterone and, accordingly, some benefits derived from MR antagonism, may be BP dependent.³ However, the aldosterone effects on which this review will concentrate are the direct, BP-independent ones, although these may, indeed, contribute together with salt and water retention to BP elevation. The reader should be cautioned, however, that many of the vascular actions of aldosterone mentioned in this article were obtained with large unphysiological doses of aldosterone, which may raise questions regarding their physiological significance.

Aldosterone has been reported to be synthesized,⁴ MRs demonstrated,⁵ and the presence of the cortisol-inactivating enzyme 11-ß-hydroxysteroid-dehydrogenase-2 identified in blood vessels.⁶ However, the production of aldosterone by blood vessels and the heart remains controversial (see below).^7,8 In addition to its classical genomic mechanisms, aldosterone exerts effects through rapid nongenomic pathways that may also be important in hypertension.⁹ Some studies suggest that aldosterone influences vascular contraction, as discussed below. Furthermore, aldosterone modulates membrane receptors and signaling molecules and influences the actions of a variety of agents to sensitize the vasculature to effects of various agents that induce vasoconstriction or result in direct effects on growth and remodeling. Vascular actions of aldosterone may be exerted on different layers of the blood vessel wall: on endothelium, smooth muscle cells of the media, or on the adventitial layer, as discussed below. The first 2 will be dealt with in succession, because there is little new knowledge on the actions of aldosterone on adventitia, which could, nonetheless, be important.

	Endothelium

Top Introduction Endothelium Smooth Muscle Cells Integrative Molecular Physiology... Conclusions References

 
Aldosterone may affect endothelium-dependent dilatory or constrictor mechanisms, either directly or indirectly via angiotensin II (Ang II)–induced effects. Ang II induces endothelial dysfunction as a result of increased oxidative stress, which may scavenge NO resulting in decreased NO bioavailability. MR blockade with spironolactone improved the impaired acetylcholine-induced relaxation in Ang II–infused rats, suggesting that aldosterone induces actions attributed to direct effects of Ang II.¹⁰ Aldosterone infusion into rats impaired endothelium-dependent relaxation in association with increased oxidative stress in the vascular wall.¹¹ This effect was reversed by the MR blocker spironolactone, as well as by endothelin receptor antagonism.¹² Previous data demonstrated that mineralocorticoid infusion was associated with enhanced endothelin expression in the endothelium of large and small arteries.¹³ Spironolactone, which had beneficial effects when added to the therapy of heart failure patients in the Randomized ALdactone Evaluation (RALES) Study,¹⁴ improved endothelial function,¹⁵ suggesting a role for aldosterone as part of the activated renin–angiotensin–aldosterone system in the endothelial dysfunction of heart failure. These results may partially explain the beneficial effects of mineralocorticoid antagonism in chronic heart failure in the RALES study, as well as in the recent Eplerenone Post-acute myocardial infarction Heart failure Efficacy and SUrvival Study (EPHESUS) with the more selective MR blocker eplerenone in postmyocardial infarction subjects.¹⁶

Chronic treatment with aldosterone resulted in impaired acetylcholine-induced relaxations of aorta in both Wistar-Kyoto and spontaneously hypertensive rats (SHRs)¹⁷ and increased aortic cyclooxygenase (COX)-2 protein expression associated with enhanced acetylcholine-induced aortic production of 13,14-dihydro-15-keto prostaglandin (PG)F₂, PGE₂, and 6-keto-PGF₁, whereas in SHRs, acetylcholine only stimulated generation of 6-keto-PGF₁. Aldosterone may, thus, produce endothelial dysfunction through COX-2 activation in normotensive and hypertensive rats. PGI₂ may be involved in endothelial dysfunction in SHR, whereas other COX-derived agents may play a role in endothelial dysfunction in normotensive rats.

Aldosterone causes nongenomic vasoconstriction by activating phospholipase C in preglomerular afferent arterioles.¹⁸ The endothelium may modulate this vasoconstrictor effect by NO release.¹⁹ Aldosterone induced a dose-dependent vasoconstriction in microperfused rabbit afferent arterioles, which was enhanced by disrupting the endothelium. Inhibition of NO synthase induced a similar effect, which was inhibited by chelerythrine, a protein kinase (PKC) inhibitor. Thapsigargin, or dantrolene, which blocks inositol 1,4,5-triphosphate (inositol triphosphate)–induced intracellular calcium release, attenuated the effect of aldosterone. Thus, these data show that endothelium-derived NO modulates the vasoconstrictor actions of aldosterone in preglomerular afferent arterioles that are mediated by the activation of inositol triphosphate and PKC pathways.

Using atomic force microscopy, Oberleithner et al²⁰ demonstrated that aldosterone induced increases of the cell nucleus of endothelial cells that could reach 15% to 28% of total cell volume in <10 minutes, effects which disappeared within 30 minutes. They postulated that aldosterone-induced nuclear swelling was a rapid genomic effect, because receptors translocated from the cytoplasm into the nucleus, and gene transcription followed, with a return of nuclear volume to normal when mRNA was exported into the cytoplasm. These authors concluded that endothelial responses to aldosterone could not be divided into acute nongenomic (<10 minutes) and sustained genomic (>10 minutes) effects, because rapid genomic effects also occurred. They also demonstrated that cultured human umbilical vein endothelial cells responded to aldosterone with sodium and water entry and swelling that was blocked by spironolactone.²¹ Swollen aldosterone-treated endothelial cells shrunk when amiloride was applied at concentrations that do not inhibit the sodium-proton exchanger (NHE) or with cariporide, a selective inhibitor of NHE, indicating that a sodium channel similar to the epithelial sodium channel of the distal nephron was involved in this aldosterone effect. Amiloride hyperpolarizes the cell as a result of the blockade of sodium channels, inducing chloride and water efflux, and cell shrinking. Oberleithner et al²⁰ suggested that because the surface of the endothelium is huge, aldosterone may reduce serum concentrations of potassium by this action and not only by its renal effects. They additionally proposed that aldosterone-induced endothelial cell swelling could increase peripheral resistance. Recently, Oberleithner²² showed that aldosterone remodels human endothelium in vitro, increasing cell size and rigidity, with protein leakage through intercellular gaps that may be the result of increased apical membrane tension. Thus, this author concluded that aldosterone makes human endothelium stiff and vulnerable, which could contribute to endothelial dysfunction.

Another recent interesting vascular effect demonstrated on rings of rat aorta was a paradoxically favorable effect of aldosterone that attenuated -adrenergic vasoconstriction through effects on the endothelium²³ mediated by increased endothelial NO synthase activation stimulated via phosphatidyl inositol 3-kinase. The physiological or pathophysiological significance of this phenomenon remains unclear, as does how this action of aldosterone may contribute to the regulation of tissue blood flow.

Garnier et al²⁴ overexpressed aldosterone synthase in the heart, with a 1.7-fold increase in myocardial aldosterone concentration, which was associated with endothelium-dependent and -independent coronary artery dysfunction without vascular inflammation or myocardial fibrosis. Impaired vascular function may be the first manifestation of aldosterone-induced cardiovascular damage. Aldosterone also increased NAD(P)H oxidase activity and reactive oxygen species (ROS) generation, and MR blockade improved endothelial function in Ang II–infused rats¹⁰ and in a high-lipid diet rabbit model.²⁵

Recent data suggest that aldosterone may elicit both vasoconstrictor and vasodilatory effects in humans. Schmidt et al²⁶ examined 48 healthy male volunteers in a randomized, placebo-controlled, double-blind crossover trial to investigate the rapid nongenomic, vascular effects of aldosterone in humans. Aldosterone increased forearm blood flow. Superimposed on aldosterone, N^G-monomethyl-L-arginine induced a greater vasoconstriction, sodium nitroprusside a reduced vasoconstriction, and phenylephrine an enhanced vasoconstriction within minutes compared with placebo. Aldosterone through rapid nongenomic effects on the endothelium may, thus, increase NO release and relax blood vessels, whereas it may act on vascular smooth muscle cells (VSMCs) to induce contraction, which agrees with recent in vitro data already mentioned.²³

	Smooth Muscle Cells

Top Introduction Endothelium Smooth Muscle Cells Integrative Molecular Physiology... Conclusions References

 
Aldosterone may be produced in cardiomyocytes in the heart^27,28 and VSMCs,^4,29 although it is not established whether concentrations achieved are high enough to exert local effects.³⁰ Indeed, in the rat heart, for example, there is little evidence that aldosterone synthase (CYP11B2) and 11(ß)-hydroxylase (CYP11B1) genes are expressed, because there is either extremely low expression of mRNA or protein for steroidogenic enzymes or they are not found at all.³¹ Cardiac and vascular MRs have also been demonstrated.⁵ Aldosterone induces fibrosis in heart, blood vessels, and kidney, particularly in the presence of high salt.^12,32–34 In addition, actions that are usually attributed to direct effects of Ang II, such as vascular remodeling, endothelial dysfunction via increased oxidative stress, and inflammation of the vascular wall and the heart, may, in fact, be mediated at least in part by aldosterone.¹⁰ Systolic BP increased by Ang II was reduced by spironolactone. In mesenteric small arteries studied on a pressurized myograph, the media/lumen ratio was increased and acetylcholine-mediated relaxation impaired by Ang II, and both were partially improved by spironolactone. Aortic NAD(P)H oxidase activity increased by Ang II was reduced by spironolactone. Plasma thiobarbituric acid–reactive substances (a marker of oxidative stress), higher in Ang II-infused rats, were normalized by spironolactone. These results suggested that aldosterone mediates some actions of Ang II usually attributed to direct actions of the peptide.

A proinflammatory cardiovascular and renal response to mineralocorticoids and particularly to aldosterone has been clearly established.^11,35–37 This may occur more frequently in the presence of high salt, which sensitizes the cardiovascular system to the nefarious cardiovascular inflammatory effects of aldosterone. Inflammatory responses have increasingly been associated with mechanisms involved in the pathophysiology of cardiovascular disease.³⁸ The mineralocorticoid-induced vascular and cardiac inflammatory response includes the upregulation of mediators such as nuclear factor B and activated protein 1, adhesion molecules such as vascular cell adhesion molecule 1 and intercellular adhesion molecule 1, and endothelin 1.³⁹

Several years ago we demonstrated that mineralocorticoids, such as deoxycorticosterone in vivo,⁴⁰ and later aldosterone in vivo and in vitro⁴¹ upregulated angiotensin receptors in VSMCs (Figure 1). Other investigators extended these findings, demonstrating that signaling of Ang II was amplified by exposure of VSMCs to aldosterone.^42–44 More recently, it has been demonstrated that aldosterone upregulates components of the renin–angiotensin system, specifically angiotensin-converting enzyme (ACE), resulting in increased local generation of Ang II (Figure 1).⁴⁵ Furthermore, aldosterone exerts direct effects on signaling in VSMCs, upregulating mitogen-activated protein (MAP) kinases.^46–48

View larger version (17K): [in this window] [in a new window]   Figure 1. Aldosterone (Aldo) interactions with the renin-angiotensin system include upregulation of both AT1 receptors (AT1R) and ACE.

In salt-loaded stroke-prone spontaneously hypertensive rats (SHRSPs) fed high- (4.2%), normal- (0.28%), or low-salt (0.03%) diets with or without eplerenone, BP rise was prevented by eplerenone in the salt-loaded rats, with little effect on control and low-salt SHRSPs.⁴⁹ The remodeling of resistance arteries and endothelial dysfunction induced by salt were prevented by eplerenone. Effects of aldosterone in SHRSPs depend on the severity of hypertension, endothelial dysfunction, and cardiac and vascular remodeling, and their improvement under eplerenone, particularly under a high-salt diet, underlines the pathophysiological involvement of aldosterone in salt-sensitive hypertension.

Increasing evidence indicates that aldosterone elicits vascular effects through nongenomic signaling pathways.^50–52 Phosphorylation of c-Src and p38MAP kinase phosphorylation, NADPH oxidase activation, and protein synthesis were dose-dependently stimulated by aldosterone in VSMCs.⁵³ These responses were abrogated by eplerenone and almost abolished by PP2, a selective c-Src inhibitor. Aldosterone-induced collagen synthesis was significantly reduced by a p38MAP kinase inhibitor. Aldosterone increased phosphorylation of c-Src, p38MAP kinase, and cortactin, a Src-specific substrate, in wild-type VSMCs, but not in c-Src-deficient VSMCs. These processes may play an important role in profibrotic actions of aldosterone and are depicted in Figure 2. Big MAP kinase 1 (BMK1) is a newly identified MAP kinase that has been shown to be involved in cell proliferation, differentiation, and survival. Ishizawa et al⁵⁴ demonstrated that aldosterone stimulated proliferation and dose-dependently activated BMK1 in rat aortic SMCs, effects inhibited by eplerenone. These effects were not inhibited by cycloheximide, suggesting that they were nongenomic. Dominant-negative MAP kinase kinase (MEK)5, which regulates BMK1, and the MEK inhibitor PD98059 inhibited, in part, aldosterone-stimulated cell proliferation. This showed that aldosterone-induced rapid nongenomic effects may participate in mechanisms of cell proliferation in cardiovascular disease.

View larger version (31K): [in this window] [in a new window]   Figure 2. Mechanisms of genomic (long-term) and nongenomic (rapid) aldosterone (Aldo) effects. Aldosterone activates the tyrosine kinase c-Src, leading to generation of ROS induced by stimulation of NAD(P)H oxidase, which MAP kinase pathway. Some of these event take place in microdomains of the plasma membrane that are cholesterol-rich, such as lipid rafts. Cross-talk with angiotensin-mediated pathways occurs through stimulation of AT1 receptors by mechanisms that remain to be explained. AT1R also signals in part through c-Src to NAD(P)H oxidase. MAP kinases are inhibited by MKP-1, which is inhibited by K-ras2A. The latter is stimulated by gene activation through the genomic effects of aldosterone, which, thus, also results in activation of the MAP kinases pathway, leading to fibrosis, growth, and vascular remodeling.

Min et al⁵⁵ examined the cross-talk of growth-promoting signaling between aldosterone and Ang II in VSMCs (Figure 2). Treatment with low doses of aldosterone (10^–12 mol/L) and Ang II (10^–10 mol/L) significantly enhanced DNA synthesis, whereas aldosterone or Ang II alone at these doses did not affect VSMC proliferation. This effect of combined aldosterone and Ang II was inhibited by olmesartan, an Ang type 1 (AT₁) receptor blocker, by spironolactone, an MEK inhibitor, PD98059, or an epidermal growth factor receptor tyrosine kinase inhibitor, AG1478. Aldosterone with Ang II at concentrations that were individually inefficacious increased extracellular signal–regulated kinase activation and Ki-ras2A expression, and reduced mitogen-activated protein kinase phosphatase-1 (MKP-1) expression. The decrease in MKP-1 and increase in Ki-ras2A expression were restored by PD98059 or AG1478 (summarized in Figure 2). These results suggest that aldosterone exerts a mitogenic effect synergistic with Ang II and that blockade of both MR and Ang II may provide enhanced protection from vascular remodeling, as already reported by Iglarz et al.⁵⁶

Ang II and aldosterone stimulate MAP kinase and ROS signaling.^47,55 Jaffe and Mendelsohn⁵⁷ showed that Ang II directly activates MRs in human coronary and aortic VSMCs (Figure 2). The presence of 11-ß-hydroxysteroid-dehydrogenase-2, necessary for mineralocorticoid action, was also demonstrated. Ang II activation of MRs was a direct effect, independent of aldosterone generation, which represents an example of receptor transactivation by the AT₁ receptor. Genes regulated by the MR stimulated by Ang II may contribute to vascular changes associated with aging, potentially different from the ones stimulated directly by the AT₁ receptor as pointed out in the Editorial accompanying the article.⁵⁸ Thus, these studies extend previous in vivo evidence of Ang II and aldosterone synergistic effects in the vasculature. Xiao et al⁵⁹ suggested that steroid production by VSMCs plays a critical role in response to Ang II and that aldosterone is required for the full proliferative response to Ang II, which could occur via modulation of expression and function of AT₁ receptors.

Fujita et al⁶⁰ infused aldosterone into the left anterior descending coronary artery of dogs, resulting in a dose-dependent reduction of coronary blood flow in both nonischemic and ischemic hearts. Fractional shortening and lactate extraction decreased. Decreases in coronary blood flow were reduced by coadministration of GF109203X, an inhibitor of PKC, but not by spironolactone. Thus, aldosterone nongenomically induces vasoconstriction via PKC-dependent pathways. Similar results have also been obtained recently in human coronary arteries obtained from heart valve donors.⁶¹ In aldosterone-potentiated coronary artery Ang II responses in proportion to extracellular signal–regulated kinase 1/2 phosphorylation and PKC activation. These effects were not blocked by spironolactone or eplerenone, suggesting that they are nongenomic.

Nongenomic effects of aldosterone on VSMC NHE have also been proposed.⁶² Both short- and long-term VSMC exposure to aldosterone increased NHE activity. Gene transcription (actinomycin D) and protein synthesis inhibitors (cycloheximide) had no effect on short-term actions but blocked long-term effects. Spironolactone and a glucocorticoid receptor antagonist (RU38486) did not influence short-term but inhibited long-term aldosterone actions. PKC inhibitors and downregulation of PKC by phorbol ester inhibited the short- and long-term effects of aldosterone. Neither mineralocorticoid nor glucocorticoid receptors are involved in NHE effects. This action was inhibited by colchicine, which indicates involvement of the cytoskeleton. Long-term aldosterone effects on VSMC NHE are mediated by mineralocorticoid and glucocorticoid receptors and involve gene transcription and protein synthesis. Both short- and long-term actions require PKC activation.

	Integrative Molecular Physiology of Vascular Effects of Aldosterone: Role in Atherosclerosis

Top Introduction Endothelium Smooth Muscle Cells Integrative Molecular Physiology... Conclusions References

 
Aldosterone, as already mentioned, increases tissue ACE activity⁴⁵ and upregulates angiotensin receptors.⁴⁰ This suggests the potential for a vicious cycle in which Ang II, through the AT₁ receptor, stimulates the production of aldosterone, which, in turn, leads to an increase in tissue ACE activity, an additional increase in Ang II, and, therefore, an additional elevation in aldosterone levels. Because Ang II and aldosterone may enhance LOX-1 receptor expression, MR blockade added to an ACE inhibitor and/or an angiotensin receptor blocker could decrease oxidized low-density lipoprotein LDL cholesterol and ROS, with a consequent increase in NO bioavailability and beneficial effects on atherosclerosis. Eplerenone reduced oxidative stress and atherosclerosis progression in apolipoprotein E^–/– mice.⁶³ Aldosterone given to apolipoprotein E^–/– mice increased macrophage oxidative stress and atherosclerosis, whereas MR blockade or an AT₁ receptor blocker reduced the atherogenic effects of aldosterone.⁶⁴ Keidar et al⁶⁴ showed that aldosterone increased macrophage-oxidized LDL cholesterol concentration and atherosclerotic plaques in the apolipoprotein E^–/– mouse. The combination of an MR blocker and an ACE inhibitor or angiotensin receptor blocker was the most effective antiatherogenic therapy. In a study of monkeys fed a high-cholesterol diet, MCP-1 and malondialdehyde-modified LDL were suppressed in the eplerenone-treated animals.⁶⁵ Intravascular ultrasound demonstrated that the aortic intima/media ratio was dose-dependently reduced in monkeys treated with eplerenone. Impaired endothelium-dependent relaxation was improved by eplerenone. ACE activity, which was increased in controls, was reduced by eplerenone. Aldosterone decreased the expression of AT₂ receptors in a model of hind-limb ischemia,⁶⁶ which provides additional evidence of a relationship to NO bioavailability and atherogenesis. Aldosterone also increased and MR blockade reduced vascular inflammation and metalloproteinase-2 and -9 activation, suggesting that aldosterone may play a role in plaque rupture.⁶⁷ These effects are not limited to the vasculature, because many of the signaling events, as well as the proinflammatory and atherogenic actions of aldosterone, are also exerted on other organs, such as the kidney, where MR blockade may be protective.⁶⁸ Renoprotective effects of eplerenone may, in part, be associated with inhibition of LOX-1–mediated adhesion molecules and the PKC–MAP kinase–p90RSK pathway, as well as improvement of endothelial function.

A question that has been addressed only in part so far is whether the increased potassium excretion and shift into the cell that aldosterone elicits with associated hypokalemia may be partially responsible for some of the effects of aldosterone on the cardiovascular system. It is well known that thiazide diuretic–induced hypokalemia is associated with increased cardiovascular risk in hypertensive patients.⁶⁹ However, aldosterone-mediated changes in potassium homeostasis do not appear to contribute to cardiac necrosis in experimental models.⁷⁰ Although some recent studies have suggested that increased endothelium-derived plasminogen activator inhibitor (PAI) 1, for example, could result from changes in potassium balance rather than direct effects of the renin– angiotensin–aldosterone system, MR blockade was shown to prevent effects of activation of the renin–angiotensin–aldosterone system on PAI 1 antigen in normotensive subjects and to improve fibrinolytic balance in hypertensive subjects independent of potassium changes.⁷¹ Whether other effects of aldosterone can be attributed to potassium shifts remains to be established, but there is evidence that potassium administration does lower BP⁷² and protects from vascular injury.⁷³ Thus, changes in potassium balance may mediate some vascular effects of aldosterone, but this remains to be unambiguously demonstrated.

	Conclusions

Top Introduction Endothelium Smooth Muscle Cells Integrative Molecular Physiology... Conclusions References

 
There is increasing literature suggesting that aldosterone exerts important physiologically and/or pathophysiologically relevant effects on the cardiovascular system and on different organs including the brain, in contrast to the classical notion that mineralocorticoids were only involved in body electrolyte and water homeostasis mediated by the kidney.⁷⁴ Increased mechanistic knowledge of this critical mediator and its many targets⁷⁵ will contribute to our ability to act therapeutically to benefit patients with cardiovascular disease, including hypertension, ischemic heart disease, stroke, heart failure, and renal disease. The current understanding of the increasingly appreciated involvement of aldosterone in hypertension acting through BP elevation, vascular damage, and cardiac fibrosis and the realization that aldosterone has complex interactions with Ang II have provided justification for the use of combined angiotensin and mineralocorticoid blockade in the treatment of hypertension and cardiac failure.^76,77

	Acknowledgments

 
The work cited was supported by grants 13570 and 37917 and a Group Grant to the Multidisciplinary Research Group on Hypertension, all from the Canadian Institutes of Health Research.

Received November 22, 2005; first decision November 27, 2005; accepted December 13, 2005.

	References

Top Introduction Endothelium Smooth Muscle Cells Integrative Molecular Physiology... Conclusions References

 
1. Fuller PJ, Young MJ. Mechanisms of mineralocorticoid action. Hypertension. 2005; 46: 1227–1235.[Abstract/Free Full Text]

2. Williams GH. Cardiovascular benefits of aldosterone receptor antagonists: what about potassium? Hypertension. 2005; 46: 265–266.[Free Full Text]

3. Griffin KA, Abu-Amarah I, Picken M, Bidani AK. Renoprotection by ACE inhibition or aldosterone blockade is blood pressure-dependent. Hypertension. 2003; 41: 201–206.[Abstract/Free Full Text]

4. Hatakeyama H, Miyamori I, Fujita T, Takeda Y, Takeda R, Yamamoto H. Vascular aldosterone. Biosynthesis and a link to angiotensin II-induced Hypertensionrophy of vascular smooth muscle cells. J Biol Chem. 1994; 269: 24316–24320.[Abstract/Free Full Text]

5. Funder JW, Pearce PT, Smith R, Campbell J. Vascular type I aldosterone binding sites are physiological mineralocorticoid receptors. Endocrinol. 1989; 125: 2224–2226.[Abstract/Free Full Text]

6. Hatakeyama H, Inaba S, Takeda R, Miyamori I. 11ß-hydroxysteroid dehydrogenase in human vascular cells. Kidney Int. 2000; 57: 1352–1357.[CrossRef][Medline] [Order article via Infotrieve]

7. Ahmad N, Romero DG, Gomez-Sanchez EP, Gomez-Sanchez CE. Do human vascular endothelial cells produce aldosterone? Endocrinology. 2004; 145: 3626–3629.[Abstract/Free Full Text]

8. Gomez-Sanchez EP, Ahmad N, Romero DG, Gomez-Sanchez CE. Origin of aldosterone in the rat heart. Endocrinology. 2004; 145: 4796–4802.[Abstract/Free Full Text]

9. Losel RM, Falkenstein E, Feuring M, Schultz A, Tillmann HC, Rossol-Haseroth K, Wehling M. Nongenomic steroid action: controversies, questions, and answers. Physiol Rev. 2003; 83: 965–1016.[Abstract/Free Full Text]

10. Virdis A, Neves MF, Amiri F, Viel E, Touyz RM, Schiffrin EL. Spironolactone improves angiotensin-induced vascular changes and oxidative stress. Hypertension. 2002; 40: 504–510.[Abstract/Free Full Text]

11. Pu Q, Neves MF, Virdis A, Touyz RM, Schiffrin EL. Endothelin antagonism on aldosterone-induced oxidative stress and vascular remodeling. Hypertension. 2003; 42: 49–55.[Abstract/Free Full Text]

12. Park JB, Schiffrin EL. ET_A receptor antagonist prevents blood pressure elevation and vascular remodeling in aldosterone-infused rats. Hypertension. 2001; 37: 1444–1449.[Abstract/Free Full Text]

13. Larivière R, Thibault G, Schiffrin EL. Increased endothelin-1 content in blood vessels of deoxycorticosterone acetate-salt hypertensive but not in spontaneously hypertensive rats. Hypertension. 1993; 21: 294–300.[Abstract/Free Full Text]

14. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez, Palensky J, Wittes J. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med. 1999; 341: 709–717.[Abstract/Free Full Text]

15. Farquharson CAJ, Struthers AD. Spironolactone increases nitric oxide bioactivity, improves endothelial vasodilator dysfunction, and suppresses vascular angiotensin I/angiotensin II conversion in patients with chronic heart failure. Circulation. 2000; 101: 594–597.[Abstract/Free Full Text]

16. Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, Bittman R, Hurley S, Kleiman J, Gatlin M; The Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study Investigators. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003; 348: 1309–1321.[Abstract/Free Full Text]

17. Blanco-Rivero J, Cachofeiro V, Lahera V, Aras-Lopez R, Marquez-Rodas I, Salaices M, Xavier FE, Ferrer M, Balfagon G. Participation of prostacyclin in endothelial dysfunction induced by aldosterone in normotensive and hypertensive rats. Hypertension. 2005; 46: 107–112.[Abstract/Free Full Text]

18. Arima S, Kohagura K, Xu HL, Sugawara A, Abe T, Satoh F, Takeuchi K, Ito S. Nongenomic vascular action of aldosterone in the glomerular microcirculation. J Am Soc Nephrol. 2003; 14: 2255–2263.[Abstract/Free Full Text]

19. Arima S, Kohagura K, Xu HL, Sugawara A, Uruno A, Satoh F, Takeuchi K, Ito S. Endothelium-derived nitric oxide modulates vascular action of aldosterone in renal arteriole. Hypertension. 2004; 43: 352–357.[Abstract/Free Full Text]

20. Oberleithner H, Reinhardt J, Schillers H, Pagel P, Schneider SW. Aldosterone and nuclear volume cycling. Cell Physiol Biochem. 2000; 10: 429–434.[CrossRef][Medline] [Order article via Infotrieve]

21. Oberleithner H, Ludwig T, Riethmüller C, Hillebrand U, Albermann L, Schäfer C, Shahin V, Schillers H. Human endothelium: target for aldosterone. Hypertension. 2004; 43: 952–956.[Abstract/Free Full Text]

22. Oberleithner H. Aldosterone makes human endothelium stiff and vulnerable. Kidney Int. 2005; 67: 1680–1682.[CrossRef][Medline] [Order article via Infotrieve]

23. Liu SL, Schmuck S, Chorazcyzewski JZ, Gros R, Feldman RD. Aldosterone regulates vascular reactivity - Short-term effects mediated by phosphatidylinositol 3-kinase-dependent nitric oxide synthase activation. Circulation. 2003; 108: 2400–2406.[Abstract/Free Full Text]

24. Garnier A, Bendall JK, Fuchs S, Escoubet B, Rochias F, Hoerter J, Nehme J, Ambroisine ML, DeAngelis N, Morineau G, d’Estienne P, Heymes C, Pinet F, Delcayre C. Cardiac-specific increase in aldosterone production induces coronary dysfunction in aldosterone synthase-transgenic mice. Circulation. 2004; 110: 1819–1825.[Abstract/Free Full Text]

25. Rajagopalan S, Duquaine D, King S, Pitt B, Patel P. Mineralocorticoid receptor antagonism in experimental atherosclerosis. Circulation. 2002; 105: 2212–2216.[Abstract/Free Full Text]

26. Schmidt BMW, Oehmer S, Delles C, Bratke R, Schneider MP, Klingbeil A, Fleischmann EH, Schmieder RE. Rapid nongenomic effects of aldosterone on human forearm vasculature. Hypertension. 2003; 42: 156–160.[Abstract/Free Full Text]

27. Silvestre JS, Heymes C, Oubenaissa A, Robert V, Aupetit-Faisant B, Carayon A, Swynghedauw B, Delcayre C. Activation of cardiac aldosterone production in rat myocardial infarction: effect of angiotensin II receptor blockade and role in cardiac fibrosis. Circulation. 1999; 99: 2694–2701.[Abstract/Free Full Text]

28. Delcayre C, Silvestre JS, Garnier A, Oubenaissa A, Cailmail S, Tatara E, Swynghedauw B, Robert V. Cardiac aldosterone production and ventricular remodeling. Kidney Int. 2000; 57: 1346–1351.[CrossRef][Medline] [Order article via Infotrieve]

29. Takeda Y, Miyamori I, Yoneda T, Iki K, Hatakeyama H, Blair IA, Hsieh F-Y, Takeda R. Production of aldosterone in isolated rat blood vessels. Hypertension. 1995; 25: 170–173.[Abstract/Free Full Text]

30. Gomez-Sanchez CE, Gomez-Sanchez EP. Cardiac steroidogenesis-new sites of synthesis, or much ado about nothing? J Clin Endocrinol Metab. 2001; 86: 5118–5120.[Free Full Text]

31. Ye P, Kenyon CJ, MacKenzie SM, Jong AS, Miller C, Gray GA, Wallace A, Ryding AS, Mullins JJ, McBride MW, Graham D, Fraser R, Connell JMC, Davies E. The aldosterone synthase (CYP11B2) and 11{beta}-hydroxylase (CYP11B1) genes are not expressed in the rat heart. Endocrinology. 2005; 146: 5287–5293.[Abstract/Free Full Text]

32. Weber KT, Sun Y, Guarda E. Structural remodeling in hypertensive heart disease and the role of hormones. Hypertension. 1994; 23: 869–877.[Abstract/Free Full Text]

33. Park JB, Schiffrin EL. Cardiac and vascular fibrosis and hypertrophy in aldosterone-infused rats: role of endothelin-1. Am J Hypert. 2002; 15: 164–169.[CrossRef][Medline] [Order article via Infotrieve]

34. Blasi ER, Rocha R, Rudolph AE, Blomme EAG, Polly ML, McMahon EG. Aldosterone/salt induces renal inflammation and fibrosis in hypertensive rats. Kidney Int. 2003; 63: 1791–1800.[CrossRef][Medline] [Order article via Infotrieve]

35. Rocha R, Chander PN, Zuckerman A, Stier CT Jr. Role of aldosterone in renal vascular injury in stroke-prone hypertensive rats. Hypertension. 1999; 33: 232–237.[Abstract/Free Full Text]

36. Rocha R, Martin-Berger CL, Yang PC, Scherrer R, Delyani J, McMahon E. Selective aldosterone blockade prevents angiotensin II/salt-induced vascular inflammation in the rat heart. Endocrinology. 2002; 143: 4828–4836.[Abstract/Free Full Text]

37. Tostes RCA, Touyz RM, He G, Chen X, Schiffrin EL. Contribution of endothelin-1 to renal activator protein-1 activation and macrophage infiltration in aldosterone-induced hypertension. Clin Sci. 2002; 103: 25S–30S.[Medline] [Order article via Infotrieve]

38. Libby P, Ridker PM, Maseri A. Inflammation and atherosclerosis. Circulation. 2002; 105: 1135–1143.[Abstract/Free Full Text]

39. Ammarguellat FZ, Gannon PO, Amiri F, Schiffrin EL. Fibrosis, matrix metalloproteinases, and inflammation in the heart of DOCA-salt hypertensive rats: Role of ET_A receptors. Hypertension. 2002; 39: 679–684.[Abstract/Free Full Text]

40. Schiffrin EL, Gutkowska J, Genest J. Effect of angiotensin II and deoxycorticosterone infusion on vascular angiotensin II receptors in rats. Am J Physiol Heart Circ Physiol. 1984; 246: H608–H614.[Abstract/Free Full Text]

41. Schiffrin EL, Franks DJ, Gutkowska J. Effect of aldosterone on vascular angiotensin II receptors in the rat. Can J Physiol Pharmacol. 1985; 63: 1522–1527.[Medline] [Order article via Infotrieve]

42. Ullian ME, Schelling JR, Linas SL. Aldosterone enhances angiotensin II receptor binding and inositol phosphate responses. Hypertension. 1992; 20: 67–73.[Abstract/Free Full Text]

43. Ullian ME, Hutchison FN, Hazen-Martin DJ, Morinelli TA. Angiotensin II-aldosterone interactions on protein synthesis in vascular smooth muscle cells. Am J Physiol Cell Physiol. 1993; 264: C1525–C1531.[Abstract/Free Full Text]

44. Ullian ME, Fine JJ. Mechanisms of enhanced angiotensin II–stimulated signal transduction in vascular smooth muscle by aldosterone. J Cell Physiol. 1994; 161: 201–208.[CrossRef][Medline] [Order article via Infotrieve]

45. Harada E, Yoshimura M, Yasue H, Nakagawa O, Nakagawa M, Harada M, Mizuno Y, Nakayama M, Shimasaki Y, Ito T, Nakamura S, Kuwahara K, Saito Y, Nakao K, Ogawa H. Aldosterone induces angiotensin-converting-enzyme gene expression in cultured neonatal rat cardiocytes. Circulation. 2001; 104: 137–139.[Abstract/Free Full Text]

46. Fiebeler A, Schmidt F, Müller DN, Park JK, Dechend R, Bieringer M, Shagdarsuren E, Breu V, Haller H, Luft FC. Mineralocorticoid receptor affects AP-1 and nuclear factor-kappaB activation in angiotensin II-Induced cardiac injury. Hypertension. 2001; 37: 787–793.[Abstract/Free Full Text]

47. Mazak I, Fiebeler A, Muller DN, Park JK, Shagdarsuren E, Lindschau C, Dechend R, Viedt C, Pilz B, Haller H, Luft FC. Aldosterone potentiates angiotensin II-induced signaling in vascular smooth muscle cells. Circulation. 2004; 109: 2792–2800.[Abstract/Free Full Text]

48. Honeck H, Gross V, Erdmann B, Kärgel E, Neunaber R, Milia AF, Schneider W, Luft FC, Schunck WH. Cytochrome P450-dependent renal arachidonic acid metabolism in desoxycorticosterone acetate-salt hypertensive mice. Hypertension. 2000; 36: 610–616.[Abstract/Free Full Text]

49. Endemann DH, Touyz RM, Iglarz M, Savoia C, Schiffrin EL. Eplerenone prevents salt-induced vascular remodeling and cardiac fibrosis in stroke-prone spontaneously hypertensive rats. Hypertension. 2004; 43: 1252–1257.[Abstract/Free Full Text]

50. Christ M, Günther A, Heck M, Schmidt BMW, Falkenstein E, Wehling M. Aldosterone, not estradiol, is the physiological agonist for rapid increases in cAMP in vascular smooth muscle cells. Circulation. 1999; 99: 1485–1491.[Abstract/Free Full Text]

51. Wehling M, Neylon CB, Fullerton M, Bobik A, Funder JW. Nongenomic effects of aldosterone on intracellular calcium in vascular smooth muscle cells. Circ Res. 1995; 76: 973–979.[Abstract/Free Full Text]

52. Manegold JC, Falkenstein E, Wehling M, Christ M. Rapid aldosterone effects on tyrosine phosphorylation in vascular smooth muscle cells. Cell Mol Biol. 1999; 45: 805–813.[Medline] [Order article via Infotrieve]

53. Callera GE, Touyz RM, Tostes RC, Yogi A, He Y, Malkinson S, Schiffrin EL. Aldosterone activates vascular p38MAP kinase and NADPH oxidase via c-Src. Hypertension. 2005; 45: 773–779.[Abstract/Free Full Text]

54. Ishizawa K, Izawa Y, Ito H, Miki C, Miyata K, Fujita Y, Kanematsu Y, Tsuchiya K, Tamaki T, Nishiyama A, Yoshizumi M. Aldosterone stimulates vascular smooth muscle cell proliferation via big mitogen-activated protein kinase 1 activation. Hypertension. 2005; 46: 1046–1052.[Abstract/Free Full Text]

55. Min LJ, Mogi M, Li JM, Iwanami J, Iwai M, Horiuchi M. Aldosterone and angiotensin II synergistically induce mitogenic response in vascular smooth muscle cells. Circ Res. 2005; 97: 434–442.[Abstract/Free Full Text]

56. Iglarz M, Touyz RM, Viel EC, Amiri F, Schiffrin EL. Involvement of oxidative stress in the profibrotic action of aldosterone - Interaction with the renin-angiotensin system. Am J Hypert. 2004; 17: 597–603.[Medline] [Order article via Infotrieve]

57. Jaffe IZ, Mendelsohn ME. Angiotensin II and aldosterone regulate gene transcription via functional mineralocortocoid receptors in human coronary artery smooth muscle cells. Circ Res. 2005; 96: 643–650.[Abstract/Free Full Text]

58. Blaxall BC, Miano JM, Berk BC. Angiotensin II: a devious activator of mineralocorticoid receptor-dependent gene expression. Circ Res. 2005; 96: 610–611.[Free Full Text]

59. Xiao F, Puddefoot JR, Barker S, Vinson GP. Mechanism for aldosterone potentiation of angiotensin II - stimulated rat arterial smooth muscle cell proliferation. Hypertension. 2004; 44: 340–345.[Abstract/Free Full Text]

60. Fujita M, Minamino T, Asanuma H, Sanada S, Hirata A, Wakeno M, Myoishi M, Okuda H, Ogai A, Okada K-I, Tsukamoto O, Koyama H, Hori M, Kitakaze M. Aldosterone nongenomically worsens ischemia via protein kinase C-dependent pathways in hypoperfused canine hearts. Hypertension. 2005; 46: 113–117.[Abstract/Free Full Text]

61. Chai W, Garrelds IM, de Vries R, Batenburg WW, van Kats JP, Jan Danser AH. Nongenomic effects of aldosterone in the human heart: interaction with angiotensin II. Hypertension. 2005; 46: 701–706.[Abstract/Free Full Text]

62. Ebata S, Muto S, Okada K, Nemoto J, Amemiya M, Saito T, Asano Y. Aldosterone activates Na⁺/H⁺ exchange in vascular smooth muscle cells by nongenomic and genomic mechanisms. Kidney Int. 1999; 56: 1400–1412.[CrossRef][Medline] [Order article via Infotrieve]

63. Keidar S, Hayek T, Kaplan M, Pavlotzky E, Hamoud S, Coleman R, Aviram M. Effect of eplerenone, a selective aldosterone blocker, on blood pressure, serum and macrophage oxidative stress, and atherosclerosis in apolipoprotein E-deficient mice. J Cardiovasc Pharmacol. 2003; 41: 955–963.[CrossRef][Medline] [Order article via Infotrieve]

64. Keidar S, Kaplan M, Pavlotzky E, Coleman R, Hayek T, Hamoud S, Aviram M. Aldosterone administration to mice stimulates macrophage NADPH oxidase and increases atherosclerosis development - A possible role for angiotensin-converting enzyme and the receptors for angiotensin II and aldosterone. Circulation. 2004; 109: 2213–2220.[Abstract/Free Full Text]

65. Takai S, Jin D, Muramatsu M, Kirimura K, Sakonjo H, Miyazaki M. Eplerenone inhibits atherosclerosis in nonhuman primates. Hypertension. 2005; 46: 1135–1139.[Abstract/Free Full Text]

66. Michel F, Ambroisine ML, Duriez M, Delcayre C, Levy BI, Silvestre JS. Aldosterone enhances ischemia-induced neovascularization through angiotensin II-dependent pathway. Circulation. 2004; 109: 1933–1937.[Abstract/Free Full Text]

67. Suzuki G, Morita H, Mishima T, Sharov VG, Todor A, Tanhehco EJ, Rudolph AE, McMahan EC, Goldstein S, Sabbah HN. Effects of long-term monotherapy with eplerenone, a novel aldosterone blocker, on progression of left ventricular dysfunction and remodeling in dogs with heart failure. Circulation. 2002; 106: 2967–2972.[Abstract/Free Full Text]

68. Kobayashi N, Hara K, Tojo A, Onozato ML, Honda T, Yoshida K, Mita Si, Nakano S, Tsubokou Y, Matsuoka H. Eplerenone shows renoprotective effect by reducing LOX-1-mediated adhesion molecule, PKC-MAPK-p90RSK, and rho-kinase pathway. Hypertension. 2005; 45: 538–544.[Abstract/Free Full Text]

69. Siscovick DS, Raghunathan TE, Psaty BM, Koepsell TD, Wicklund KG, Lin X, Cobb L, Rautaharju PM, Copass MK, Wagner EH. Diuretic therapy for hypertension and the risk of primary cardiac arrest. N Engl J Med. 1994; 330: 1852–1857.[Abstract/Free Full Text]

70. Martinez DV, Rocha R, Matsumura M, Oestreicher E, Ochoa-Maya M, Roubsanthisuk W, Williams GH, Adler GK. Cardiac damage prevention by eplerenone: comparison with low sodium diet or potassium loading. Hypertension. 2002; 39: 614–618.[Abstract/Free Full Text]

71. Ma J, Albornoz F, Yu C, Byrne DW, Vaughan DE, Brown NJ. Differing effects of mineralocorticoid receptor-dependent and -independent potassium-sparing diuretics on fibrinolytic balance. Hypertension. 2005; 46: 313–320.[Abstract/Free Full Text]

72. Siani A, Strazzullo P, Giacco A, Pacioni D, Celentano E, Mancini M. Increasing the dietary potassium intake reduces the need for antihypertensive medication. Ann Intern Med. 1991; 15: 753–759.

73. Sugimoto K, Tobian L, Ishimitsu T, Lange JM. High potassium diets greatly increase growth-inhibiting agents in aortas of hypertensive rats. Hypertension. 1992; 19: 749–752.[Abstract/Free Full Text]

74. Kuhlman D, Ragan C, Ferrebee JW, Atchley DW, Loeb RF. Toxic effects of deoxycorticosterone esters in dogs. Science. 1939; 90: 496–497.[Free Full Text]

75. Schiffrin EL. The many targets of aldosterone. Hypertension. 2004; 43: 938–940.[Free Full Text]

76. Tanabe A, Naruse M, Hara Y, Sato A, Tsuchiya K, Nishikawa T, Imaki T, Takano K. Aldosterone antagonist facilitates the cardioprotective effects of angiotensin receptor blockers in hypertensive rats. J Hypertens. 2004; 22: 1017–1023.[CrossRef][Medline] [Order article via Infotrieve]

77. Kambara A, Holycross BJ, Wung P, Schanbacher B, Ghosh S, McCune SA, Bauer JA, Kwiatkowski P. Combined effects of low-dose oral spironolactone and captopril therapy in a rat model of spontaneous hypertension and heart failure. J Cardiovasc Pharmacol. 2003; 41: 830–837.[CrossRef][Medline] [Order article via Infotrieve]

This article has been cited by other articles:

				S. Messaoudi, P. Milliez, J.-L. Samuel, and C. Delcayre Cardiac aldosterone overexpression prevents harmful effects of diabetes in the mouse heart by preserving capillary density FASEB J, July 1, 2009; 23(7): 2176 - 2185. [Abstract] [Full Text] [PDF]

				J. R. Sowers, A. Whaley-Connell, and M. Epstein Narrative Review: The Emerging Clinical Implications of the Role of Aldosterone in the Metabolic Syndrome and Resistant Hypertension Ann Intern Med, June 2, 2009; 150(11): 776 - 783. [Abstract] [Full Text] [PDF]

				F. R. Perez, F. Venegas, M. Gonzalez, S. Andres, C. Vallejos, G. Riquelme, J. Sierralta, and L. Michea Endothelial Epithelial Sodium Channel Inhibition Activates Endothelial Nitric Oxide Synthase via Phosphoinositide 3-Kinase/Akt in Small-Diameter Mesenteric Arteries Hypertension, June 1, 2009; 53(6): 1000 - 1007. [Abstract] [Full Text] [PDF]

				A. Whaley-Connell, J. Habibi, Y. Wei, A. Gutweiler, J. Jellison, C. E. Wiedmeyer, C. M. Ferrario, and J. R. Sowers Mineralocorticoid receptor antagonism attenuates glomerular filtration barrier remodeling in the transgenic Ren2 rat Am J Physiol Renal Physiol, May 1, 2009; 296(5): F1013 - F1022. [Abstract] [Full Text] [PDF]

				E. Ritz How Little Aldosterone is Able to Raise Blood Pressure? Clin. J. Am. Soc. Nephrol., April 1, 2009; 4(4): 703 - 710. [Full Text] [PDF]

				Y. Wei, A. T. Whaley-Connell, J. Habibi, J. Rehmer, N. Rehmer, K. Patel, M. Hayden, V. DeMarco, C. M. Ferrario, J. A. Ibdah, et al. Mineralocorticoid Receptor Antagonism Attenuates Vascular Apoptosis and Injury via Rescuing Protein Kinase B Activation Hypertension, February 1, 2009; 53(2): 158 - 165. [Abstract] [Full Text] [PDF]

				B. Pitt The measurement of plasma aldosterone in patients post-myocardial infarction Eur. Heart J., October 2, 2008; 29(20): 2451 - 2452. [Full Text] [PDF]

				A. M. Dorrance Stroke Therapy: Is Spironolactone the Holy Grail? Endocrinology, August 1, 2008; 149(8): 3761 - 3763. [Full Text] [PDF]

				A.C. Montezano, G.E. Callera, A. Yogi, Y. He, R.C. Tostes, G. He, E.L. Schiffrin, and R.M. Touyz Aldosterone and Angiotensin II Synergistically Stimulate Migration in Vascular Smooth Muscle Cells Through c-Src-Regulated Redox-Sensitive RhoA Pathways Arterioscler. Thromb. Vasc. Biol., August 1, 2008; 28(8): 1511 - 1518. [Abstract] [Full Text] [PDF]

				L. M. Ruilope Aldosterone, Hypertension, and Cardiovascular Disease: An Endless Story Hypertension, August 1, 2008; 52(2): 207 - 208. [Full Text] [PDF]

				G. Lastra, A. Whaley-Connell, C. Manrique, J. Habibi, A. A. Gutweiler, L. Appesh, M. R. Hayden, Y. Wei, C. Ferrario, and J. R. Sowers Low-dose spironolactone reduces reactive oxygen species generation and improves insulin-stimulated glucose transport in skeletal muscle in the TG(mRen2)27 rat Am J Physiol Endocrinol Metab, July 1, 2008; 295(1): E110 - E116. [Abstract] [Full Text] [PDF]

				A. W. Krug and M. Ehrhart-Bornstein Aldosterone and Metabolic Syndrome: Is Increased Aldosterone in Metabolic Syndrome Patients an Additional Risk Factor? Hypertension, May 1, 2008; 51(5): 1252 - 1258. [Full Text] [PDF]

				F. Iwashima, T. Yoshimoto, I. Minami, M. Sakurada, Y. Hirono, and Y. Hirata Aldosterone Induces Superoxide Generation via Rac1 Activation in Endothelial Cells Endocrinology, March 1, 2008; 149(3): 1009 - 1014. [Abstract] [Full Text] [PDF]

				E. L. Schiffrin New Twist to the Role of the Renin-Angiotensin System in Heart Failure: Aldosterone Upregulates Renin-Angiotensin System Components in the Brain Hypertension, March 1, 2008; 51(3): 622 - 623. [Full Text] [PDF]

				J. Bauersachs and D. Fraccarollo More NO-No More ROS: Combined Selective Mineralocorticoid Receptor Blockade and Angiotensin-Converting Enzyme Inhibition for Vascular Protection Hypertension, March 1, 2008; 51(3): 624 - 625. [Full Text] [PDF]

				C. Savoia, R. M. Touyz, F. Amiri, and E. L. Schiffrin Selective Mineralocorticoid Receptor Blocker Eplerenone Reduces Resistance Artery Stiffness in Hypertensive Patients Hypertension, February 1, 2008; 51(2): 432 - 439. [Abstract] [Full Text] [PDF]

				M.-L. Ambroisine, J. Favre, P. Oliviero, C. Rodriguez, J. Gao, C. Thuillez, J.-L. Samuel, V. Richard, and C. Delcayre Aldosterone-Induced Coronary Dysfunction in Transgenic Mice Involves the Calcium-Activated Potassium (BKCa) Channels of Vascular Smooth Muscle Cells Circulation, November 20, 2007; 116(21): 2435 - 2443. [Abstract] [Full Text] [PDF]

				A. W. Krug, S. Kopprasch, C. G. Ziegler, S. Dippong, R. A. Catar, S. R. Bornstein, H. Morawietz, and M. Gekle Aldosterone Rapidly Induces Leukocyte Adhesion to Endothelial Cells: A New Link Between Aldosterone and Arteriosclerosis? Hypertension, November 1, 2007; 50(5): e156 - e157. [Full Text] [PDF]

				H. Oberleithner, C. Riethmuller, H. Schillers, G. A. MacGregor, H. E. de Wardener, and M. Hausberg Plasma sodium stiffens vascular endothelium and reduces nitric oxide release PNAS, October 9, 2007; 104(41): 16281 - 16286. [Abstract] [Full Text] [PDF]

				A. H. Karara, V. Hanes, A. Alonso, P. Ni, N. Poola, R. Silang, H. Blode, and R. A. Preston Pharmacokinetics and Pharmacodynamics of Drospirenone-Estradiol Combination Hormone Therapy Product Coadministered With Hydrochlorothiazide in Hypertensive Postmenopausal Women J. Clin. Pharmacol., October 1, 2007; 47(10): 1292 - 1302. [Abstract] [Full Text] [PDF]

				S. A. Cooper, A. Whaley-Connell, J. Habibi, Y. Wei, G. Lastra, C. Manrique, S. Stas, and J. R. Sowers Renin-angiotensin-aldosterone system and oxidative stress in cardiovascular insulin resistance Am J Physiol Heart Circ Physiol, October 1, 2007; 293(4): H2009 - H2023. [Abstract] [Full Text] [PDF]

				M. C. Chappell Emerging Evidence for a Functional Angiotensin-Converting Enzyme 2-Angiotensin-(1-7)-Mas Receptor Axis: More Than Regulation of Blood Pressure? Hypertension, October 1, 2007; 50(4): 596 - 599. [Full Text] [PDF]

				B. Pitt Promise of Mineralocorticoid Receptor Blockade in Asymptomatic Left Ventricular Dysfunction Hypertension, September 1, 2007; 50(3): 461 - 462. [Full Text] [PDF]

				C. Rosendorff, H. R. Black, C. P. Cannon, B. J. Gersh, J. Gore, J. L. Izzo Jr, N. M. Kaplan, C. M. O'Connor, P. T. O'Gara, and S. Oparil REPRINT Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention Hypertension, August 1, 2007; 50(2): e28 - e55. [Full Text] [PDF]

				B. Pitt and G. S. Pitt Added Benefit of Mineralocorticoid Receptor Blockade in the Primary Prevention of Sudden Cardiac Death Circulation, June 12, 2007; 115(23): 2976 - 2982. [Full Text] [PDF]

				C. Grossmann, A. W. Krug, R. Freudinger, S. Mildenberger, K. Voelker, and M. Gekle Aldosterone-induced EGFR expression: interaction between the human mineralocorticoid receptor and the human EGFR promoter Am J Physiol Endocrinol Metab, June 1, 2007; 292(6): E1790 - E1800. [Abstract] [Full Text] [PDF]

				C. Rosendorff, H. R. Black, C. P. Cannon, B. J. Gersh, J. Gore, J. L. Izzo Jr, N. M. Kaplan, C. M. O'Connor, P. T. O'Gara, and S. Oparil Treatment of Hypertension in the Prevention and Management of Ischemic Heart Disease: A Scientific Statement From the American Heart Association Council for High Blood Pressure Research and the Councils on Clinical Cardiology and Epidemiology and Prevention Circulation, May 29, 2007; 115(21): 2761 - 2788. [Full Text] [PDF]

				Y. Hirono, T. Yoshimoto, N. Suzuki, T. Sugiyama, M. Sakurada, S. Takai, N. Kobayashi, M. Shichiri, and Y. Hirata Angiotensin II Receptor Type 1-Mediated Vascular Oxidative Stress and Proinflammatory Gene Expression in Aldosterone-Induced Hypertension: The Possible Role of Local Renin-Angiotensin System Endocrinology, April 1, 2007; 148(4): 1688 - 1696. [Abstract] [Full Text] [PDF]

				D. A. Calhoun Aldosterone and Cardiovascular Disease: Smoke and Fire Circulation, December 12, 2006; 114(24): 2572 - 2574. [Full Text] [PDF]

				J. L. Turgeon, M. C. Carr, P. M. Maki, M. E. Mendelsohn, and P. M. Wise Complex Actions of Sex Steroids in Adipose Tissue, the Cardiovascular System, and Brain: Insights from Basic Science and Clinical Studies Endocr. Rev., October 1, 2006; 27(6): 575 - 605. [Abstract] [Full Text] [PDF]

				T. Marumo, H. Uchimura, M. Hayashi, K. Hishikawa, and T. Fujita Aldosterone Impairs Bone Marrow-Derived Progenitor Cell Formation Hypertension, September 1, 2006; 48(3): 490 - 496. [Abstract] [Full Text] [PDF]

				J. Bauersachs and D. Fraccarollo Endothelial NO Synthase Target of Aldosterone Hypertension, July 1, 2006; 48(1): 27 - 28. [Full Text] [PDF]

				M. Epstein and M. E. Safar Aldosterone and Large Artery Vessels Hypertension, June 1, 2006; 47(6): e24 - e24. [Full Text] [PDF]

This Article Extract Full Text (PDF) All Versions of this Article: 47/3/312    most recent 01.HYP.0000201443.63240.a7v1 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 HighWire Citing Articles via Google Scholar Google Scholar Articles by Schiffrin, E. L. Search for Related Content PubMed PubMed Citation Articles by Schiffrin, E. L. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Related Collections Remodeling Smooth muscle proliferation and differentiation Endothelium/vascular type/nitric oxide Other Vascular biology