Provided insight into the role of aldosterone, the salt-retaining hormone, and the mineralocorticoid receptors in organs such as the heart and kidney. This has been valuable in advancing understanding of high blood pressure and heart failure.
Aldosterone is a hormone with an outsized influence on the cardiovascular system. It regulates how the body retains salt — and when it misfires, the consequences for the heart, kidneys and blood vessels can be severe.
From the 1980s, a cardiovascular endocrinology team — initially at Prince Henry's Hospital, then at the Baker Institute — pioneered the study of aldosterone and the mineralocorticoid receptors (MR) it acts through. A key discovery was that these receptors were not limited to the kidney, as previously thought. Baker Institute scientists demonstrated their presence in the central nervous system, the heart and the vasculature — establishing that aldosterone's influence reaches far beyond the regulation of salt.
The team also identified the enzyme that normally prevents aldosterone from activating receptors in the kidney, and published the first gene sequence of that enzyme — a breakthrough that unlocked understanding of a series of hypertensive disorders.
The clinical significance has been profound. Aldosterone is now recognised as an important contributor to heart failure, and the drug spironolactone — which blocks its action — has become standard care in progressive heart failure. Research also established that primary aldosteronism, which may account for a significant proportion of hypertension cases, is associated with markedly increased risk of atrial fibrillation, stroke and heart attack. Every one of these clinical insights was built on the foundational work done at the Baker Institute.
