Aldosterone: with an unhealthy diet (high sodium, low potassium) a little extra may go a long way toward development of hypertension.

摘要

In targeting the distal nephron, aldosterone functions to prevent sodium loss and avoid hyperkalemia. Not long after its discovery more than a half-century ago, Conn reported that autonomous hypersecretion of aldosterone (primary aldosteronism) was the cause of the increase in blood pressure in a small subset of patients with hypertension. Aldosterone as a contributor to risk for hypertension did not advance much beyond this point until years later when it was shown that primary aldosteronism was in fact not rare but was the cause of hypertension in ~10% of those with hypertension. We also now know that ~40% of patients with resistant hypertension have primary aldosteronism or at least have aldosterone levels high enough that the blood pressure responds to mineralocorticoid receptor blockade. Can the role of aldosterone be extended even further?