The role of aldosterone receptor blockade in the management of cardiovascular disease.

The recent revival of interest in aldosterone receptor antagonists for the treatment of cardiovascular disease has been underpinned by fresh insights into the pathophysiological role of aldosterone in cardiovascular disease, especially with regard to its widespread 'non-epithelial' actions, as well as by key findings from dinical studies. The therapeutic efficacy of spironolactone (Pharmacia Corp) in severe chronic heart failure is established. Emerging evidence from an extensive development program for eplerenone (Pharmacia Corp), a novel selective aldosterone receptor antagonist, may further expand the evidence base for aldosterone receptor antagonism, including its potential in treating hypertension. Importantly, eplerenone does not appear to cause the hormonal side effects observed with spironolactone.