Table 3.

 Clinical indications for aldosterone blockade

Definite

• Reduces mortality in chronic heart failure and post-myocardial infarction LV dysfunction

• Reduces blood pressure in virtually all hypertensives as both primary and add on treatment

Probable

• Reduces target organ damage (alone or in addition to ACE inhibitors)

–left ventricular hypertrophy in hypertension

–microalbuminuria including diabetics

Future possibilities

• Renoprotective in early renal disease

• Reduces cerebral damage in cerebrovascular disease

• Reduces cardiovascular events in HOPE/EUROPA type vascular patients (in addition to ACE inhibitors)