Toward a broader understanding of aldosterone in congestive heart failure

Karl T. Weber, Yao Sun, Linus A. Wodi, Ahmad Munir, Eiman Jahangir, Robert A. Ahokas, Ivan C. Gerling, Arnold E. Postlethwaite, Kenneth J. Warrington

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Discovered some 50 years ago, aldosterone (ALDO) has come to be recognised as a mineralocorticoid hormone with well-known endocrine properties in epithelial cells that contribute to the pathophysiology of congestive heart failure. This includes Na+ resorption at the expense of K+ excretion in classic target tissues: kidneys, colon, sweat and salivary glands. Though less well known, Mg2+ excretion is likewise enhanced by ALDO, while adrenal ALDO secretion is regulated by extracellular Mg2+ ([Mg2+]o). An emerging body of information has and continues to identify other endocrine actions of ALDO receptor-ligand binding. They include: promoting an efflux of cytosolic free Mg2+, or [Mg2+]i, in exchange for Na+ in such non-epithelial cells as peripheral blood mononuclear cells; its influence on endothelial cell function; and its central actions that involve regulation of cerebrospinal fluid composition produced by epithelial cells of the choroid plexus, activity of the hypothalamic paraventricular nucleus involved in Na+ appetite, Na+ and H2O excretion and sympathetic nerve activity, and the regulation of TNF-α production from central and/or peripheral sources. Extra-adrenal steroidogenesis and auto/paracrine properties of ALDO generated de novo in the cardiovasculature are now under investigation and preliminary findings suggest they contribute to tissue repair. The past decade has witnessed a revival of interest in this steroid molecule. In years to come, an even broader understanding of ALDO's contribution to the pathophysiology of congestive heart failure will undoubtedly emerge.

Original languageEnglish (US)
Pages (from-to)155-163
Number of pages9
JournalJRAAS - Journal of the Renin-Angiotensin-Aldosterone System
Issue number3
StatePublished - Sep 2003


  • Aldosterone
  • Magnesium
  • Oxi/nitrosative stress
  • Peripheral blood mononuclear cells

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology


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