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Current Hypertension Reports

Erschienen in:

01.07.2015 | Hypertension and the Kidney (RM Carey, Section Editor)

Aldosterone and the Mineralocorticoid Receptor: Risk Factors for Cardiometabolic Disorders

verfasst von: Rajesh Garg, Gail K. Adler

Erschienen in: Current Hypertension Reports | Ausgabe 7/2015

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Abstract

Preclinical studies have convincingly demonstrated a role for the mineralocorticoid receptor (MR) in adipose tissue physiology. These studies show that increased MR activation causes adipocyte dysfunction leading to decreased production of insulin-sensitizing products and increased production of inflammatory factors, creating an environment conducive to metabolic and cardiovascular disease. Accumulating data also suggest that MR activation may be an important link between obesity and metabolic syndrome. Moreover, MR activation may mediate the pathogenic consequences of metabolic syndrome. Recent attempts at reversing cardiometabolic damage in patients with type 2 diabetes using MR antagonists have shown promising results. MR antagonists are already used to treat heart failure where their use decreases mortality and morbidity over and above the use of traditional therapies alone. However, more data are needed to establish the benefits of MR antagonists in diabetes, obesity, and metabolic syndrome.

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82.••

Matsumoto Y, Mori Y, Kageyama S, Arihara K, Sugiyama T, Ohmura H, et al. Spironolactone reduces cardiovascular and cerebrovascular morbidity and mortality in hemodialysis patients. J Am Coll Cardiol. 2014;63(6):528–36. This study enrolled 309 oligoanuric hemodialysis patients to assess whether spironolactone treatment reduces the incidence of cardiovascular and cerebrovascular morbidity and mortality. After 3-year follow-up, the primary outcome (composite of death or hospitalization for cardiovascular or cerebrovascular events) occurred in 5.7% of patients in the spironolactone (25 mg daily) group and in 12.5% of patients in the control group (p = 0.016). Serious hyperkalemia led to treatment discontinuation in only 3 patients (1.9%). Thus MR blockade using spironolactone may substantially reduce the risk of cardiovascular and cerebrovascular disease among hemodialysis patients.PubMedCrossRef

Titel: Aldosterone and the Mineralocorticoid Receptor: Risk Factors for Cardiometabolic Disorders
verfasst von: Rajesh Garg
Gail K. Adler
Publikationsdatum: 01.07.2015
Verlag: Springer US
Erschienen in: Current Hypertension Reports / Ausgabe 7/2015
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI: https://doi.org/10.1007/s11906-015-0567-8

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Vorsicht, erhöhte Blutungsgefahr nach PCI!

Update Innere Medizin