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(Circulation. 2006;114:2572-2574.)
© 2006 American Heart Association, Inc.

Editorial

Aldosterone and Cardiovascular Disease

Smoke and Fire

David A. Calhoun, MD

From the Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, Ala.

Correspondence to David A. Calhoun, MD, 430 BMR2, 1530 3rd Ave South, Birmingham, AL 35294-2180. E-mail dcalhoun@uab.edu

Key Words: Editorials • aldosterone • heart failure • hypertension • myocardial infarction • aldosterone antagonists

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

	Introduction

 
A growing body of evidence links aldosterone excess to the development and progression of several different cardiovascular disease processes, including hypertension, congestive heart failure, chronic kidney disease, coronary artery disease, and stroke. The association with aldosterone is particularly strong for hypertension, with multiple studies independently suggesting that aldosterone contributes broadly to the development and severity of hypertension separate from the presence of classically defined primary aldosteronism (PA). In these same studies, renin activity, if measured, has not been related to blood pressure levels, which suggests an autonomous role of aldosterone in causing hypertension separate from renin–angiotensin II.

Article p 2604

Prospective and cross-sectional studies suggest that aldosterone contributes both to the development and the severity of hypertension. In a recent prospective analysis done as part of the ongoing Framingham Offspring Study, serum plasma aldosterone levels in normotensive subjects predicted subsequent increases in blood pressure and in the development of incident hypertension.¹ During a 4-year follow-up, subjects in the highest quartile of serum aldosterone level, relative to subjects in the lowest quartile, had a 1.60-fold higher risk of significantly increased blood pressure and a 1.61-fold higher risk of hypertension.

Cross-sectional studies demonstrate a significant correlation between plasma aldosterone levels and untreated 24-hour ambulatory blood pressure levels. In an evaluation of black American and white French Canadian subjects, supine and standing plasma aldosterone levels were significantly related to daytime and nighttime systolic and diastolic blood pressure levels in the black American subjects.^2,3 In the white Canadian subjects, standing aldosterone levels correlated with . . . [Full Text of this Article]

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