The Study Of Spironolactone On Cardiovascular Collagen Turnover With Essential Hypertension

Background and Object: Essential hypertension is a common cardiovascular disease which can cause serious complication of heart, brain, kidney and peripheral vessels. The remodeling of heart and vascular contributes to the complications of hypertension. Besides parenchymal cell, such as myocardial cell and vascular smooth muscle cell, interstitial collagen also takes place obvious remodeling, which playes an essential role in the development of hypertension and hypertension complications. Recently, more and more evidences suggested that aldosterone can cause myocardial and vascular fibrosis through affecting collagen turnover. At the same time, experimental studies have showed that cardiovascular tissue can completely generate aldosterone. Extra-adrenal aldosterone plays an important role in cardiovascular stiffness. In animal model, aldosterone receptor antagonist can reduce myocardial fibrosis, improve heart function. In vivo studies of human, coadministration of the aldosterone receptor antagonist and ACE inhibitor may better reduce serum Pâ…¢NP and LVMI than only ACE inhibitor and obviously reduced the accumulation of collagen in cardiac interstitium. The recently completed RALES (Randamized Aldactone Evaluation) trial and EPHESUS (Eplerenone's Neurohormonal Efficacy and Survival Study) trial suggested that aldosterone receptor antagonist may obviously reduce the mortality and morbidity of severe heart failure and acute myocardial infarction respectively. All the before studies of spironolactone on collagen turnover in essential hypertension were based on its major role of reducing blood...