Table I.

 Pathophysiologic Actions of Aldosterone That Promote Hypertension and Increase Cardiovascular Risk

Sodium retention/volume expansion

Reduction in vascular compliance

Promotion of endothelial dysfunction

Upregulation of angiotensin II receptors

Potentiation of the pressor responses of angiotensin II

Increases in sodium influx in vascular smooth muscle cells

Fibrosis in the heart, kidneys, and vasculature

Activation of plasminogen activator inhibitor 1

Stimulation of transforming‐growth factor β1

Stimulation of reactive oxygen species

Hypertrophy of vascular smooth muscle cells and myocardial cells

Increase in blood lipid levels

Hypokalemia resulting in increased potential for cardiac arrhythmias, glucose intolerance, insulin resistance

Hypomagnesemia resulting in increased potential for cardiac arrhythmias