Blocking Aldosterone Improves Cardiovascular Risk Precisely
The last post discussed the effect of aldosterone in causing chronic disease and the power of specifically blocking the activation of the mineralocorticoid receptor by that molecule. There is much more to the story. This is one of the best examples of precision medicine that can be applied to large populations very inexpensively.
Increased aldosterone activity levels related to increased abdominal fat are a root cause of increased cardiovascular risk factors. High aldosterone leads directly to increased oxidant production, increased inflammation, insulin resistance, reduced insulin production, endothelial dysfunction (reduced nitric oxide production), increased sugar production in the liver, and increased sympathetic tone. These abnormalities in turn lead to abnormal structure and function of the heart, arteries, and kidney. They impact every organ and every cell in the body.
Aldosterone produces these effects by activating the mineralocorticoid receptor in the upper right corner of the diagram. Blocking the MR receptor with spironolactone, eplerenone, or finerenone reverses all these effects to slow the progression of cardiovascular disease and chronic kidney disease. That is precision medicine to address the predictable consequences of extra abdominal weight. It is also important to realize that aldosterone switches on genes that should be switched off and these changes persist even after weight loss. That is why small doses of MR blockers are still important to provide protection for organs and cells. Use precision medicine now to protect yourself and your patients with extra abdominal fat and other risk factors.