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Aldosterone promotes thrombosis formation after arterial injury in mice.

To the Editor:

The renin/angiotensin/aldosterone system (RAAS) has been broadly implicated in the pathogenesis of cardiovascular disease.1 Angiotensin converting enzyme (ACE) inhibitors have been shown to be beneficial in reducing cardiovascular events.2 The specific role of aldosterone in promoting ischemic cardiovascular disease is unclear. Recent evidence suggests that subjects with primary aldosteronism are at increased risk of cardiovascular events compared with subjects with essential hypertension,3 suggesting a potential direct role of aldosterone in mediating ischemic events. Human studies have demonstrated that pharmacological blockade of aldosterone with spironolactone in congestive heart failure patients leads to reduced cardiovascular mortality, even in the presence of ACE inhibition.4 Because many cardiovascular events are attributable to thrombosis in the setting of atherosclerosis, we used an animal model to directly determine the effect of elevated aldosterone on atherosclerosis as well as arterial thrombus formation after …