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Antialdosteronics renaissance in the contemporary cardiology


Authors: M. Štejfa
Published in: Kardiol Rev Int Med 2005, 7(1): 21-24

Overview

We present an overview on synthesis and effects of aldosterone and their competitive inhibitors spironolactone and eplerenone. We briefly mention the indications, contraindications and adverse effects of the nonspecific inhibitor spironolactone in patients with primary and secondary hyperaldosteronism and its significance in hypertension treatment. Small doses of spironolactone (25 mg daily) in chronic heart failure NYHA II–IV represent a new indication, where the antiproliferative effect on progression of heart failure takes place (RALES study). Eplerenon is a specific inhibitor and presents a minimum of adverse effects. It was successfully tested in patients with hypertensive left ventricular hypertrophy (4E study) and in patients suffering from chronic heart failure (the EPHESUS study).

Keywords:
aldosterone – spironolactone – eplerenone – chronic heart failure – left ventricular hypertrophy – hypertension


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Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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