The Role of Mineralocorticoid Receptors in Pathogenesis of Hypertension

Abstract

Mineralocorticoids, among which aldosterone is the most important factor, have great influence on cardio-vascular system: they regulate ion transport in renal distal tubules causing chloride and sodium retention and potassium and hydrogen secretion. They maintain proper blood pressure, have positive inotropic effect and may cause heart-fibrosis. Aldosterone and other mineralocorticoids act through intracellular and membrane receptors (MRs). Thus mineralocorticoids regulate genes’ transciption and have their own intracellular mediators (HSP, calcineurin, cAMP, inositol-1,4,5-trisphosphate). One of the most important factors determining aldosterone selectivity for MRs is the presence of 11-b-hydroxysteroid dehydrogenase (11-b-HSD). It is supposed that some manifestations of arterial blood pressure can be connected with MRs system disturbance and some changes in 11-b-HSD activity. Mediation on the receptor level appears to be very promising way of treatment of many aldosterone-related diseases, that is why a general interest in selective antagonists of MRs lowering the arterial blood pressure is taken.