TITLE

Aldosterone Receptor Antagonists in the Medical Management of Chronic Heart Failure

AUTHOR(S)
Tang, W. H. Wilson; Parameswaran, Anoop C.; Maroo, Anjli P.; Francis, Gary S.
PUB. DATE
December 2005
SOURCE
Mayo Clinic Proceedings;Dec2005, Vol. 80 Issue 12, p1623
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The benefits of aldosterone receptor antagonists (spironolactone and eplerenone) for patients with heart failure were shown in 2 recent randomized controlled trials. Some of the proposed mechanisms of action of aldosterone antagonists are (1) inhibition of myocardial and vascular remodeling, (2) blood pressure reduction, (3) decreased collagen deposition, (4) decreased myocardial stiffness, (5) prevention of hypokalemia and arrhythmia, (6) modulation of nitric oxide synthesis, and (7) immunomodulation. Like many hormone receptors, the aldosterone receptor can be either nuclear or membrane bound. Most of the activities of the aldosterone receptor are subserved by the nuclear receptors and often lead to alterations in gene transcription. Although these agents are well tolerated in carefully selected patient populations that meet the inclusion criteria of large clinical trials, their use in unselected elderly patients with heart failure and multiple comorbidities has been associated with a significant risk of hyperkalemia and renal failure. Although no convincing data exist to predict which individual patients will respond to aldosterone inhibition, patients with more severe heart failure and those with acute myocardial infarction with concomitant heart failure or left ventricular dysfunction are most likely to respond. Theoretically, aldosterone receptor antagonists may also be beneficial in patients with more and to moderate systolic heart failure or even in those with diastolic heart failure, although direct evidence is still lacking.
ACCESSION #
19169304

 

Related Articles

  • Aldosterone trial boost.  // Pulse;11/17/2010, Vol. 70 Issue 35, p4 

    The article reports on the benefits of the aldosterone agonists in reducing risk of heart failure in patients with heart disease.

  • Benefits and Consequences of Aldosterone Antagonists for HF. Kuritzky, Louis // OB/GYN Clinical Alert;Feb2013 Clinical Briefs in Primary Care, p3 

    The article focuses on the results of clinical trials regarding the benefits and consequences of aldosterone antagonist therapy in chronic heart failure (CHF) patients.

  • Aldosterone use in heart failure.  // Infectious Disease Alert;Dec2009 Pharmacology Watch Suppleme, p1 

    The article discusses research on the clinical use of aldosterone for heart failure (HF). It references a study published in the 2009 issue of the "Journal of the American Medical Association." The study included 43,000 patients who were hospitalized due to HF between 2005 and 2007. Study...

  • Some ACCLAIM for immune modulation in chronic heart failure. Lindsay, Alistair // Heart;May2008, Vol. 94 Issue 5, p676 

    The article discusses the study of the effect of the immunomodulation on the morbidity and mortality of 2426 patients with class II-IV heart failure. The study was done through a placebo-controlled trial called Advanced Chronic Heart Failure Clinical Assessment of Immune Modulation Therapy...

  • Lack of adherence in heart failure therapy.  // Healthcare Benchmarks & Quality Improvement;May2010, Vol. 17 Issue 5, p58 

    This article discusses a study which examined the adherence to recommendations for the treatment of heart failure. The study showed that about one-third of patients with heart failure had received the recommended therapy. Nancy M. Albert, director of nursing research and innovation in the...

  • Aldosterone use in heart failure.  // Primary Care Reports;Dec2009 Pharmacology Watch Supp, p1 

    The article discusses the use of aldosterone antagonists in patient suffering from moderate-to-severe heart failure (HF) and dystolic functions. A study in the "Journal of the American Medical Association" the use of aldosterone antagonists was minimal although it can improve treatment of...

  • Missed opportunity: Aldosterone antagonists in heart failure.  // Primary Care Reports;Jan2010 Clinical Briefs, p2 

    The article discusses research on the use of aldosterone antagonists against heart failure. It references the study "Use of Aldosterone Antagonists in Heart Failure," by N. M. Albert et al, published in a 2009 issue of the "Journal of the American Medical Association" (JAMA). It was found that...

  • Missed opportunity: Aldosterone antagonists in heart failure.  // Clinical Cardiology Alert;Jan2010 Supplement, Vol. 15 Issue 1, p2 

    The article discusses research on the effect of aldosterone antagonists in patients with heart failure. It references a study by N. M. Albert et al published in a 2009 issue of the "Journal of the American Medical Association." Patients included in the study each received one aldosterone...

  • Benefits and Consequences of Aldosterone Antagonists for HF.  // Neurology Alert;Feb2013, Vol. 31 Issue 6, p3 

    An abstract that shows the clinical trial data on the benefits and consequences of Aldosterone antagonists for heart failure is presented.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics