Safety aspects of aldosterone-blocking drugs

The central role of aldosterone in cardiovascular and renal disease forces the need to use aldosterone blockers in both processes. Spironolactone and eplerenone have been shown to control blood pressure, to improve the outcomes of patients with heart failure, post.MI and also in those with chronic kidney disease and proteinuria. These positive effects are counteracted by the potential development of hyperkalemia and other side-effects particularly gynecomastia in the case of spironolactone. An adequate estimation of the level of glomerular filtration rate has to performed to calculate the risk or even more the contraindication of the use of these drugs to avoid hyperkalemia.