Mineralocorticoid Receptor Blockers: Novel Selective Nonsteroidal Mineralocorticoid Receptor Antagonists

Purpose of Review Recently, nonsteroidal mineralocorticoid receptor (MR) antagonists (MRAs), which have been proposed to be called MR blockers (MRBs), have become available for clinical use, but their clinical role is unknown. We reviewed the clinical roles of MRAs and MRBs based on previous knowled...

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Bibliographic Details
Published in:Current hypertension reports 2020-02, Vol.22 (3), p.21-21, Article 21
Main Authors: Sueta, Daisuke, Yamamoto, Eiichiro, Tsujita, Kenichi
Format: Article
Language:English
Subjects:
Blood pressure
Cardiac function
Cardiology
Clinical trials
Disease prevention
Drug dosages
Edema
Family Medicine
General Practice
Heart attacks
Heart failure
Hypertension
Internal Medicine
Medical prognosis
Medicine
Medicine & Public Health
Metabolic Diseases
Metabolic disorders
Nephrology
Potassium
Prevention of Hypertension: Public Health Challenges(Y Yano
Primary Care Medicine
Public health
Section Editor
Studies
Topical Collection on Prevention of Hypertension: Public Health Challenges
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Summary:Purpose of Review Recently, nonsteroidal mineralocorticoid receptor (MR) antagonists (MRAs), which have been proposed to be called MR blockers (MRBs), have become available for clinical use, but their clinical role is unknown. We reviewed the clinical roles of MRAs and MRBs based on previous knowledge and as demonstrated in representative clinical trials. Recent Findings Steroidal MRAs, such as spironolactone and eplerenone, inhibit the action of aldosterone and cortisol in MRs expressed in several organs and cell types, and accumulating clinical studies have revealed that they exert hypotensive and cardiorenal protective effects. Recently, MRBs, including finerenone and esaxerenone, have been developed and are expected to lower the risk of hyperkalemia, which is common when steroidal MRAs are used. Although the differences between MRAs and MRBs in clinical practice have not yet been established, further studies in this field are expected to broaden our understanding. Summary MRBs exert antihypertensive and cardiorenal protective effects, and their potency is thought to be far superior to that of MRAs, because MRBs have both strong MR inhibitory action and high selectivity. Thus, MRBs could be a promising agent for the treatment of hypertension and cardiorenal, cerebral, and metabolic disorders.
ISSN:1522-6417
1534-3111
DOI:10.1007/s11906-020-1023-y