Aplicaciones y proyecciones de los antagonistas del receptor de mineralocorticoides en el tratamiento de patologías cardiovasculares

Fernando J. Verdugo, Felipe A. Montellano, Juan E. Carreño, Elisa T. Marusic

Producción científica: Contribución a una revistaArtículo de revisiónrevisión exhaustiva

4 Citas (Scopus)


In recent years, much attention has focused on the role of aldosterone and mineralocorticoid receptors (MRs) in the pathophysiology of hypertension and cardiovascular disease. Patients with primary aldosteronism, in whom angiotensin II levels are low, have a higher incidence of cardiovascular complications than patients with essential hypertension. The Randomized Aldactone Evaluation Study (RALES) demonstrated that adding a non-specific MR antagonist, spironolactone, to a standard therapy that included angiotensin-converting enzyme (ACE) inhibitors, loop diuretics, and digoxin, significantly reduced morbidity and mortality in patients with moderate to severe heart failure. Similarly, the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) showed that the addition of a selective MR antagonist (ARM), eplerenone, to an optimal medical therapy reduces morbidity and mortality among patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure. These data suggest that aldosterone induces cardiac injury through activation of MRs and support the notion that MR blockade has beneficial effects on aldosterone-dependent cardiac injury, through mechanisms that cannot be simply explained by hemodynamic changes. Although, MRA are highly effective in patients with heart failure, the risk of hyperkalemia should not be overlooked. Serious hyperkalemia events were reported in some MRA clinical trials; however these risks can be mitigated through appropriate patient selection, dose selection, patient education, monitoring, and follow-up.
Título traducido de la contribuciónMineralocorticoid receptor antagonists and therapeutic strategies of cardiovascular damage
Idioma originalEspañol
Páginas (desde-hasta)61-71
Número de páginas11
PublicaciónRevista Medica de Chile
EstadoPublicada - 2014

Palabras clave

  • Aldosterone
  • Cardiovascular diseases
  • Mineralocorticoid receptor antagonists
  • Spironolactone


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