Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Heart failure

Aldosterone antagonists are underused by clinicians

Aldosterone antagonists decrease the mortality of patients with heart failure, but an observational study by Albert and colleagues has found that a surprisingly low number of patients receive aldosterone antagonists before discharge from hospital. This article highlights potential reasons for why there is such an underuse of efficient drugs in heart failure.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

References

  1. Pitt, B. et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N. Engl. J. Med. 341, 709–717 (1999).

    Article  CAS  Google Scholar 

  2. Pitt, B. et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N. Engl. J. Med. 348, 1309–1321 (2003).

    Article  CAS  Google Scholar 

  3. Albert, N. M. et al. Use of aldosterone antagonists in heart failure. JAMA 302, 1658–1665 (2009).

    Article  CAS  Google Scholar 

  4. Tait, S. A., Tait, J. F. & Coghlan, J. P. The discovery, isolation and identification of aldosterone: reflections on emerging regulation and function. Mol. Cell. Endocrinol. 217, 1–21 (2004).

    Article  CAS  Google Scholar 

  5. Menard, J. The 45-year story of the development of an anti-aldosterone more specific than spironolactone. Mol. Cell. Endocrinol. 217, 45–52 (2004).

    Article  CAS  Google Scholar 

  6. Brilla, C. G., Matsubara, L. S. & Weber, K. T. Anti-aldosterone treatment and the prevention of myocardial fibrosis in primary and secondary hyperaldosteronism. J. Mol. Cell. Cardiol. 25, 563–575 (1993).

    Article  CAS  Google Scholar 

  7. Benard, L. et al. Effects of aldosterone on coronary function. Pharmacol. Reports 61, 58–66 (2009).

    Article  CAS  Google Scholar 

  8. Milliez, P. et al. Evidence for an increased rate of cardiovascular events in patients with primary aldosteronism. J. Am. Coll. Cardiol. 45, 1243–1248 (2005).

    Article  CAS  Google Scholar 

  9. Ambroisine, M. L. et al. Aldosterone-induced coronary dysfunction in transgenic mice involves the calcium-activated potassium (BKCa) channels of vascular smooth muscle cells. Circulation 116, 2435–2443 (2007).

    Article  CAS  Google Scholar 

  10. Di Zhang, A. et al. Cross-talk between mineralocorticoid and angiotensin II signaling for cardiac remodeling. Hypertension 52, 1060–1067 (2008).

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Claude Delcayre.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Samuel, JL., Delcayre, C. Aldosterone antagonists are underused by clinicians. Nat Rev Cardiol 7, 125–127 (2010). https://doi.org/10.1038/nrcardio.2009.244

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrcardio.2009.244

This article is cited by

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing