Home > Treatment > What Are Aldosterone Antagonists?

What Are Aldosterone Antagonists?

By: Kathryn Senior PhD - Updated: 1 Jan 2013 | comments*Discuss
 
Aldosterone Antagonists Heart Failure

Aldosterone antagonists are drugs that are often used to treat heart failure. This occurs when the heart becomes damaged and then cannot act as an efficient and effective pump. Failure of the left ventricle leads to left ventricular heart failure, which causes swelling in the legs, feet and ankles, and general tiredness. When the right ventricle fails, the most common symptoms are breathlessness and tiredness, as blood is not pumped efficiently to and from the lungs.

Without treatment, heart failure becomes worse over time leading to severe disability and a loss of quality of life. Using drugs to eliminate some of the worst symptoms and to help the heart to work as hard as it is able to can really help make a big difference.

Aldosterone Antagonists are Diuretics

This means that the drugs work on the kidneys to stop so much sodium being absorbed from the fluid passing through the kidneys. This helps to reduce the amount of sodium that is excreted in the urine, which allows more water to pass from the blood, causing diuresis – the production of greater volumes of urine.

As more water is leaving the body, this reduces the swelling in the legs, feet and ankles in people with left ventricular heart failure, and also reduces the excess fluid on the lungs of people with right ventricular heart failure. Reducing the overall volume of the blood also helps to relieve some of the strain on the heart, which often enlarges in heart failure to try to compensate.

Aldosterone antagonists basically block the action of aldosterone, a hormone that acts on the kidney to conserve water. Preventing this activity stops the body conserving water, allowing blood pressure and blood volume to fall. Although they are mainly used to treat heart failure, they can also be used to treat high blood pressure.

Examples of Aldosterone Antagonists

The first aldosterone antagonist to be developed to treat heart failure was spironolactone. More recently developed additions to the drug class include eplerenone, canrenone, prorenone and mexreonone.

Eplerenone is often used to treat people who have had a serious heart attack that has damaged the heart so much that it starts to fail. People with left ventricular heart failure can benefit from greatly reduced risk of another heart attack, and of dying from the effects of their initial heart attack, if they are given eplerenone within 3-14 days.

Side Effects of Aldosterone Antagonists

This class of drugs are described as a useful ‘second line treatment’ for heart failure. This means they are often given as a second drug, together with a first choice treatment, to reduce the symptoms of heart failure and to also treat other conditions such as high blood pressure.

The older aldosterone antagonist spironolactone has more side effects that the later drugs in this class that have been developed. Spironolactone can lead to changes in secondary sexual characteristics in women treated with it for heart failure – often their voice becomes deeper and their pattern of body hair growth starts to resemble that of a man. Some women also find that their periods become very irregular. Men treated with this drug can also suffer hormonal effects – and they can develop female characteristics such as breasts, which can become quite painful as they enlarge.

Aldosterone agonists all decrease the amount of potassium that exits the body in the urine, so they must not be taken with other types of diuretics or with drugs to treat fungal infections, as the level of the potassium in the blood might become dangerously high. People given this class of drug are advised not to eat foods that are particularly high in potassium, as this makes the problems worse. Foods such as fruit juice, poultry, fish, beef, fresh fruits and dried fruits must all be cut out of the diet, leading to a very restricted range of foods that can still be enjoyed.

You might also like...
Share Your Story, Join the Discussion or Seek Advice..
Why not be the first to leave a comment for discussion, ask for advice or share your story...

If you'd like to ask a question one of our experts (workload permitting) or a helpful reader hopefully can help you... We also love comments and interesting stories

Title:
(never shown)
Firstname:
(never shown)
Surname:
(never shown)
Email:
(never shown)
Nickname:
(shown)
Comment:
Validate:
Enter word:
Topics
Latest Comments
  • williniejacobs
    Re: Hole in the Heart
    I was diagnosed of Chronic Obstructive Pulmonary Disease (COPD) in 2012 at the age of 63. I had been a heavy smoker, my symptoms started out…
    27 November 2019
  • Abbsx
    Re: Hole in the Heart: What Happens Next?
    i was born with a hole in my heart , when i run i get heart palpitation like symptoms, i have asthma so it might be to…
    15 November 2019
  • MAC
    Re: Hole in the Heart
    I attended pulmonary rehabilitation several years ago and learned the proper techniques for taking my medications, but the medications do not…
    6 November 2019
  • James
    Re: What is Heart Block?
    Hi I have a pacemaker following heart block. Doctors don't know what caused it and told me i should be just fine from now on (I'm only 57…
    28 October 2019
  • puzzled
    Re: Stable and Unstable Angina: What's the Difference?
    Hi, Bit of a puzzler. Was admitted by ambulance after becoming ill. Was grey, soaking with sweat,…
    28 October 2019
  • susantrevino
    Re: Hole in the Heart
    Four years ago I experienced a severe breathing and wheezing problem that my doctor diagnosed as chronic bronchitis with dust allergy. A year…
    26 July 2019
  • Yuri
    Re: Hole in the Heart: What Happens Next?
    I was told I was born with a hole in my heart and the hospital gave my mom this paper that said VSD, but we right away…
    9 July 2019
  • Ritu
    Re: Hole in the Heart: What Happens Next?
    I also have a hole in heart there is 2 hole dr.say that there no treatment bcoz hole is too big I'm always tnsn for…
    8 July 2019
  • Santosh
    Re: Heart Condition Dextrocardia Explained
    Hello there, I have dextrocardia with sinus inversus viscerem. Along with this I have microtia III. Also my eyelid…
    25 May 2019
  • Russell's trouble
    Re: Why Does My Heart Beat Faster After Sweet Food?
    Husband suffered heart attack, 63 years old, smoked and drank. Sunday fixed 2 blockages with stents using…
    17 May 2019