A Neglected Factor in Female Hypertension?

By Jane Farrell

Doctors treating women with high blood pressure should consider measuring their level of aldosterone, a hormone that at high levels damages the cardiovascular system, according to new research.

If aldosterone levels are high, they should consider prescribing drugs that directly target the hormone’s receptor, says Dr. Eric Belin de Chantemele, physiologist in the Vascular Biology Center and associate professor in the Department of Medicine at the Medical College of Georgia at Augusta University.

“We are finding more evidence that higher aldosterone levels in women translate to higher blood pressure and that the most effective way to treat hypertensive women likely is to target this hormone and its receptor,” Belin de Chantemele said, referencing what appears to be another clear distinction emerging between men and women.

At baseline, women have more aldosterone than men and those levels are known to soar in the face of obesity and diabetes. Now there is increasing evidence that aldosterone is a major driver of hypertension, potentially in women of any girth.

Belin de Chantemele notes that clinical studies already have provided some evidence that mineralocorticoid receptor blockers, like the old hypertensive agent spironolactone, work better at reducing blood pressure and cardiovascular risk in women than men.

Still it’s often only when other drugs fail, that drugs that directly affect aldosterone by blocking its receptor are tried. Rather mineralocorticoid receptor blockers, which work as a diuretic, are more commonly used as part of a cocktail for heart failure.

Belin de Chantemele is chairing an international symposium focusing on new discoveries and the translational potential of aldosterone and its mineralocorticoid receptor in cardiovascular disease. The symposium is part of the 38th World Congress of the International Union of Physiological Sciences in Rio de Janeiro.