Aldosterone antagonists belong to a category of drugs that helps treat heart disease and certain types of kidney disease by blocking the actions of aldosterone, a steroid-like hormone that can cause high blood pressure and other serious problems related to heart function. The human body produces aldosterone under normal conditions to retain water and salt, but individuals with heart failure can have excessive amounts of aldosterone that create problems with potassium levels, congestion, heart enlargement, and blood vessel scarring. Medications that are classified as aldosterone antagonists act by binding to aldosterone receptors in the blood vessels and heart to block the hormone. These drugs can sometimes be used in conjunction with other heart or kidney medications.
Treatment with aldosterone antagonists is usually for patients with severe or moderate systolic heart failure, seen as the reduced ability of the heart to pump normally. It is also used in some individuals who display heart failure symptoms following a coronary event. Often, aldosterone blockers can quickly reduce heart failure symptoms, including leg swelling and breathing difficulties, caused by excess buildup of body fluids. These medications are typically given together with another type of diuretic, or fluid-reducing, drug.
Patients with high blood pressure, diabetic nephropathy, or heart failure are sometimes treated with ACE inhibitors or angiotension-II receptor blockers, which suppress levels of aldosterone in the individual's bloodstream. These drugs can frequently lead to a condition known as aldosterone escape, in which levels of aldosterone gradually begin to return to pre-treatment status despite the use of medication. Aldosterone antagonists, which can be used concurrently with other aldosterone-blocking medications, are believed to decrease the occurrence of aldosterone escape.
Aldosterone antagonists can sometimes cause hormone changes in women, leading to symptoms such as lowered voice or excess growth of hair. A drug category known as selective aldosterone receptor antagonists, or SARAs, is believed to have fewer hormone-related side effects. One significant risk of treatment with any variety of aldosterone blocker drug is the development of hyperkalemia, a dangerously high level of potassium in the blood. This condition can lead to heart arrhythmia or other severe disruptions of heart function.
Individuals being treated with aldosterone antagonists are advised to avoid eating foods rich in potassium. These foods can include fruits or fruit juice, certain vegetables, wheat bran, and some kinds of meat. Patients using these medications should also avoid taking non-steroidal anti-inflammatory drugs, or NSAIDs. COX-2 inhibitors are also contraindicated, as well as any medicine or supplement that has the potential to raise potassium levels.