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Circulation. 2002;105:2212-2216
Published online before print April 22, 2002, doi: 10.1161/01.CIR.0000015854.60710.10
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(Circulation. 2002;105:2212.)
© 2002 American Heart Association, Inc.


Basic Science Reports

Mineralocorticoid Receptor Antagonism in Experimental Atherosclerosis

Sanjay Rajagopalan, MD; Damon Duquaine, BS; Steven King, PhD; Bertram Pitt, MD; Paresh Patel, MD

From the Departments of Internal Medicine (S.R., D.D., S.K., B.P.) and Psychiatry (P.P.), University of Michigan, Ann Arbor, Mich.

Correspondence to Sanjay Rajagopalan, MD, Section of Vascular Medicine, Division of Cardiology, L3119 Women’s Hospital, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0273. E-mail srajagop@ umich.edu

Background Aldosterone has been implicated in the effects of angiotensin II in the vasculature. We hypothesized that there is local expression of the mineralocorticoid receptor (MR) in the vasculature and that the use of a selective aldosterone receptor antagonist (SARA) improves endothelial function in early atherosclerosis.

Methods and Results New Zealand rabbits were placed on normal chow or 1% cholesterol diets, randomized to placebo or SARA (eplerenone, 50 mg/kg twice daily), and killed at the end of 6 weeks for various studies. In the hyperlipidemic (HL) chow group, there was a 2.3-fold increase in superoxide (O2·-) generation. SARA normalized O2· - generation in intact aortas and reduced NADH and NADPH oxidase activity to basal levels (0.31±0.04 and 0.27±0.02 in HL versus 0.16±0.05 and 0.07±0.02 in HL-SARA, respectively; P<0.01 by ANOVA). This was associated with improvements in peak relaxations to the endothelial-dependent agonist acetylcholine (82±6% in HL-SARA versus 61±4 in HL; P<0.01 by ANOVA; ED50 6.8x10-8 mol/L in HL-SARA and 1.2x10-7 mol/L in HL; P=NS) to near-normal levels. Vessels from the HL group demonstrated hyperreactivity to angiotensin II that could not be corrected with SARA. Plasma aldosterone levels by radioimmunoassay demonstrated a 4- to 5-fold increase in response to SARA but no differences with lipid feeding. Real-time reverse transcriptase–polymerase chain reaction studies revealed expression of MR in the aorta of HL rabbits and those of controls.

Conclusions MR antagonism improves endothelial function and reduces O2·- generation in diet-induced atherosclerosis. Targeting aldosterone by blocking its receptor has potential antiatherosclerotic effects.


Key Words: atherosclerosis • nitric oxide • superoxide • endothelium




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