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Annual Review of Physiology

Volume 86, 2024

The Mineralocorticoid Receptor in the Vasculature: Friend or Foe?

Abstract

Originally described as the renal aldosterone receptor that regulates sodium homeostasis, it is now clear that mineralocorticoid receptors (MRs) are widely expressed, including in vascular endothelial and smooth muscle cells. Ample data demonstrate that endothelial and smooth muscle cell MRs contribute to cardiovascular disease in response to risk factors (aging, obesity, hypertension, atherosclerosis) by inducing vasoconstriction, vascular remodeling, inflammation, and oxidative stress. Extrapolating from its role in disease, evidence supports beneficial roles of vascular MRs in the context of hypotension by promoting inflammation, wound healing, and vasoconstriction to enhance survival from bleeding or sepsis. Advances in understanding how vascular MRs become activated are also reviewed, describing transcriptional, ligand-dependent, and ligand-independent mechanisms. By synthesizing evidence describing how vascular MRs convert cardiovascular risk factors into disease (the vascular MR as a foe), we postulate that the teleological role of the MR is to coordinate responses to hypotension (the MR as a friend).

Keyword(s): aldosterone, cardiovascular disease, inflammation, mineralocorticoid receptor, oxidative stress
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/content/journals/10.1146/annurev-physiol-042022-015223
2024-02-12
2024-05-05
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/content/journals/10.1146/annurev-physiol-042022-015223
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The Mineralocorticoid Receptor in the Vasculature: Friend or Foe?
Annual Review of Physiology 86, 49 (2024); https://doi.org/10.1146/annurev-physiol-042022-015223
/content/journals/10.1146/annurev-physiol-042022-015223
/content/journals/10.1146/annurev-physiol-042022-015223
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