The spironolactone renaissance

Expert Opinion on Investigational Drugs
S A Doggrell, L Brown

Abstract

Until recently, spironolactone was considered only as an antagonist at the aldosterone receptors of the epithelial cells of the kidney and was used clinically in the treatment of hyperaldosteronism and, occasionally, as a K(+)-sparing diuretic. The spironolactone renaissance started with the experimental finding that spironolactone reversed aldosterone-induced cardiac fibrosis by a cardiac action. Experimentally, spironolactone also has direct effects on blood vessels. Spironolactone reduces vascular fibrosis and injury, inhibits angiogenesis, reduces vascular tone and reduces portal hypertension. The rationale for the Randomized Aldactone Evaluation Study (RALES) of spironolactone in heart failure was that 'aldosterone escape' occurred through non-angiotensin II mechanisms. The RALES clinical trial was stopped early when it was shown that there was a 30% reduction in risk of death among the spironolactone patients. In RALES, spironolactone also reduced hospitalisation for worsening heart failure and improved the symptoms of heart failure. Other recent clinical trials have shown that spironolactone reduces cardiac and vascular collagen turnover, improves heart variability, reduces ventricular arrhythmias, improves endothelial d...Continue Reading

References

Jul 1, 1992·Cardiovascular Research·C G Brilla, K T Weber
May 1, 1996·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·F NevensJ Fevery
Dec 1, 1995·European Heart Journal·A D Struthers
Jun 1, 1997·Arteriosclerosis, Thrombosis, and Vascular Biology·A BenetosM E Safar
Dec 17, 1998·The New England Journal of Medicine·A Ganguly
Apr 30, 1999·Hypertension Research : Official Journal of the Japanese Society of Hypertension·A SatoT Saruta
May 21, 1999·British Journal of Clinical Pharmacology·A D Struthers
Jun 18, 1999·Journal of Molecular and Cellular Cardiology·S H SlightK T Weber
Sep 2, 1999·The New England Journal of Medicine·K T Weber
Apr 13, 2000·The American Journal of Cardiology·E RietzschelD L Clement
May 3, 2000·Clinical Endocrinology·P M SpritzerF Lhullier
Jul 11, 2000·Journal of Molecular and Cellular Cardiology·P Lijnen, V Petrov
Aug 15, 2000·Journal of Cardiovascular Pharmacology·R SorrentinoA Pinto
Sep 12, 2000·Current Hypertension Reports·D DuprezD L Clement
Sep 15, 2000·Journal of the American College of Cardiology·T TsutamotoM Kinoshita
Sep 20, 2000·Journal of Hypertension·M Stowasser, R D Gordon

❮ Previous
Next ❯

Citations

Mar 11, 2006·Apoptosis : an International Journal on Programmed Cell Death·M MikkelsenK Bendtzen
Jun 18, 2004·Kidney International·Marie LeclercDenis Couchourel
Jun 24, 2008·Pediatric Dermatology·Andrew C KrakowskiLawrence F Eichenfield
Mar 13, 2014·Expert Opinion on Pharmacotherapy·Decio ArmaniniLuciana Bordin
Jun 27, 2002·Expert Opinion on Pharmacotherapy·Sheila A Doggrell, Lindsay Brown
Sep 16, 2011·Journal of Pharmaceutical Sciences·Zsombor K NagyGyörgy Marosi
Jul 26, 2011·Molecular and Cellular Endocrinology·Smail MessaoudiFrederic Jaisser
Sep 18, 2010·European Journal of Pharmacology·Amteshwar Singh Jaggi, Nirmal Singh
Dec 8, 2006·Medical Hypotheses·James Jeffrey BradstreetDaniel Rossignol
Jan 12, 2007·The Journal of Clinical Hypertension·Murray Epstein
Nov 30, 2007·Ophthalmic Research·Ljiljana OtasevicUwe Pleyer
Aug 3, 2002·Hypertension·John C BarbatoRoberto Franco-Saenz
Jan 17, 2003·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Joseph FrancisRobert B Felder
May 30, 2020·European Journal of Heart Failure·Andreas P KalogeropoulosJames C Fang
Jul 1, 2018·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Simone RomanoPietro Minuz
Mar 12, 2008·The Journal of Organic Chemistry·Yongbin HanFrederick A Villamena

❮ Previous
Next ❯

Related Concepts

Related Feeds

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.