Role of central mineralocorticoid receptors in cardiovascular disease.

Mineralocorticoids act directly through their receptors in specific centers in the central nervous system, kidneys, heart, and vascular smooth muscle to mediate hemodynamic homeostasis. These steroids also modulate renal and cardiovascular function indirectly through the autonomic nervous system. Complex homeostatic mechanisms under normal hormonal control become pathogenic when there is an excess of regulatory hormone. Experiments in which mineralocorticoid receptor antagonists or antisense oligodeoxynucleotides were administered centrally have clearly shown that centrally mediated effects on salt appetite, baroreceptor function, and autonomic drive to the renal and cardiovascular systems are crucial to the pathogenesis of hypertension and cardiovascular disease of hyperaldosteronism, and certain forms of genetic hypertension.