Symptoms and the Distress They Cause

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Abstract
BLOCKADE OF the renin-angiotensin-aldosterone system with angiotensin-converting enzyme inhibitors and angiotensin II antagonists has become a major element in the treatment of a wide range of cardiovascular and renal conditions. Over the past decade there has been growing recognition that aldosterone contributes to the pathologic conditions induced by activation of this system.1-6 In animal models, blockade of the effects of aldosterone at the receptor level have had a substantial positive influence on natural history.1-4 Clinical development has been limited because spironolactone, the only aldosterone antagonist that was available until recently, is poorly tolerated.7-9 The recent development of eplerenone, an aldosterone receptor antagonist with greater specificity for the mineralocorticoid receptor than spironolactone, has created the possibility that improved therapeutics will follow.1-4