Anoop publishes in the Mayo Clinic Proceedings
Aldosterone Receptor Antagonists in the Medical Management of Chronic Heart Failure W. H. WILSON TANG, MD; ANOOP C. PARAMESWARAN, MD, MPH; ANJLI P. MAROO, MD; GARY S. FRANCIS, MD The benefits of aldosterone receptor antagonists (spironolactone and eplerenone) for patients with heart failure were shown in 2 recent randomized controlled trials. Some of the proposed mechanisms of action of aldosterone antagonists are (1) inhibition of myocardial and vascular remodeling, (2) blood pressure reduction, (3) decreased collagen deposition, (4) decreased myocardial stiffness, (5) prevention of hypokalemia and arrhythmia, (6) modulation of nitric oxide synthesis, and (7) immunomodulation. Like many hormone receptors, the aldosterone receptor can be either nuclear or membrane bound. Most of the activities of the aldosterone receptor are subserved by the nuclear receptors and often lead to alterations in gene transcription. Although these agents are well tolerated in carefully selected patient popu
