This non-promotional medical education website has been developed by AstraZeneca and is intended for healthcare professionals outside of the US.
Welcome to
Think Aldo
An expert-led initiative advancing knowledge and science around an often overlooked driver of hypertension and cardiovascular and kidney disease: aldosterone.1,2
This website provides the latest scientific insights and educational resources, curated by a network of experts, to support scientific exchange and enhance clinical practice.
Meet the experts behind the initiatives
Explore the foundations of aldosterone
Discover scientific resources and publications
Putting the Second ‘A’ Back in RAAS: Shining a Light on Aldosterone
Hear our expert network explain why we need to Think about the role of Aldosterone in cardiovascular and kidney disease.
It’s Time to Rethink How We Understand and Address Aldosterone
Aldosterone, part of the renin–angiotensin–aldosterone system (RAAS), regulates sodium reabsorption, water retention and blood pressure control.3
Physiologically, high sodium should suppress aldosterone, and low sodium should increase aldosterone – an evolved loop that conserves volume in scarcity and prevents excess in abundance.4–6
However, modern-day chronic salt excess disrupts this feedback loop, so in the setting of high salt intake – when aldosterone should be minimal – even normal levels of aldosterone may pose risk.6–8
Emerging evidence suggests this abnormal aldosterone production – or aldosterone dysregulation – can drive uncontrolled hypertension and increase cardiovascular and kidney risk, beyond its classical role in volume homeostasis.9–11
In addition, elevated levels of aldosterone are associated with mechanisms such as inflammation, fibrosis and vascular dysfunction, contributing to end-organ damage, which may occur independent of blood pressure effects.12–15
Scientific Resources
Explore our scientific resources and recommended on-topic publications to help further your understanding of how aldosterone can drive uncontrolled hypertension and end-organ damage.16,17
Why Can Aldosterone’s Role Be Pathological in
Modern-Day Humans?
Join Dr Anand Vaidya as he discusses how aldosterone’s evolutionary role in fluid and electrolyte balance becomes maladaptive in today’s high-salt environment, where even mild excess can be inappropriate and increase cardiovascular and kidney risk.
Optimising Hypertension Management: Best Practice in Australia
Find out how Professor Alta Schutte’s work in the National Taskforce of Australia is supporting best practice in hypertension.
Optimising Hypertension Management: Best Practice in
Poland
Hear Professor Krzysztof Narkiewicz share best practice approaches to hypertension care in Poland.
How is Aldosterone Regulated as Part of the RAAS, and What Are its Key Actions in the Kidney?
Explore how aldosterone regulated as part of the RAAS, and what the key actions are within the kidney. Developed in collaboration with Professor David Wheeler
How Does Aldosterone Exhibit its Effect on the MR and
Non-MR Pathway, and What Are the Downstream Signalling Effects?
Discover how aldosterone exhibits its effect on the mineralocorticoid receptor (MR) and non-MR pathway, and what the downstream signalling effects are. Developed in collaboration with Professor Michael Böhm
Overcoming Barriers in Hypertension Management
Explore expert perspectives on identifying and overcoming clinical inertia in hypertension across multiple points in the patient journey. Developed in collaboration with Professor Luiz Bortolotto, Professor Krzysztof Narkiewicz, Professor Alta Schutte and Professor Jiguang Wang
What is Driving Difficult-to-Control Hypertension?
Download summary slides for Module 1: What is Driving Difficult-to-Control Hypertension? Developed in collaboration with Professor Krzysztof Narkiewicz, Professor Alta Schutte, Dr Anand Vaidya and Professor Jiguang Wang
Aldosterone Pathophysiology: Mechanisms and Clinical Consequences
Download summary slides for Module 2: Aldosterone Pathophysiology: Mechanisms and Clinical Consequences. Developed in collaboration with Professor Luiz Bortolotto, Professor Erika Jones, Professor Rhian Touyz and Professor Hirotaka Shibata
A Deep Dive into Aldosterone Dysregulation and its Impact
Download summary slides for Module 3: A Deep Dive into Aldosterone Dysregulation and its Impact.
Developed in collaboration with Professor Hirotaka Shibata, Dr Raymond Townsend, Dr Anand Vaidya and Professor Bryan Williams
Understanding the Pathological Role of Aldosterone
Join Professor Rhian Touyz as she unpacks the complex signalling pathways of aldosterone and explores the link between aldosterone activity and cardiovascular and kidney risk.
Exploring the Evidence for Aldosterone‑Mediated Mechanisms of Disease
Listen to Professor Bryan Williams dive into the continuum of aldosterone dysregulation and how this contributes to hypertension and cardiovascular and kidney harm.
A Historical Overview of the Clinical Evolution of Aldosterone
Join Dr Raymond Townsend as he explores the history of aldosterone and the evolution of its clinical significance.
Putting the 'A' Back in RAAS
Watch Professor Konstantinos Tsioufis deliver a short presentation highlighting the role of aldosterone within RAAS in normal and pathological scenarios and download the accompanying slides for your own use.
Putting the 'A' Back in RAAS
Watch Professor Konstantinos Tsioufis deliver a short presentation highlighting the role of aldosterone within RAAS in normal and pathological scenarios and download the accompanying slides for your own use.
Why Think Aldosterone in Hypertension Management?
Explore what our experts think about aldosterone when treating patients with hypertension or cardiovascular and kidney disease.
Mechanism of Disease of Aldosterone
Dive deeper into the core biological principles of aldosterone, highlighting aldosterone’s action within the body and where current therapies fall short.
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- Papadopoulou-Marketou N, et al. Hyperaldosteronism. In: Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. 2000
- Vaidya A, et al. Am J Hypertens 2022;35:967–988
- Scott JH, et al. Physiology, Aldosterone. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2023
- Strizzi CT, et al. Int J Mol Sci 2025;26:8829
- Bioletto F, et al. Int J Mol Sci 2022;23:4803
- Schweda F. Pflugers Arch 2015;467:565–576
- Chen L, et al. Horm Metab Res 2024;56:99–106
- WHO. Sodium reduction. Available at: https://www.who.int/news-room/fact-sheets/detail/sodium-reduction (Accessed March 2026)
- Townsend RR, et al. Am J Hypertens 2026;39:161–170
- Monticone S, et al. Lancet Diabetes Endocrinol 2018;6:41–50
- Parksook WW, Williams GH. Cardiovasc Res 2023;119:28–44
- Brown JM. J Am Heart Assoc 2024;13:e030142
- Verhovez A, et al. Curr Signal Transduc Ther 2012;7:132–141
- Otsuka H, et al. Int J Mol Sci 2023;24:5370
- Tomaschitz A, et al. Eur Heart J 2010;31:1237–1247
- Inoue K, et al. Hypertension 2020;76:113–120
- McEvoy JW, et al. Eur Heart J 2024;45:3912–4018
Welcome to Think Aldo
Welcome to Think Aldo, an expert-led initiative advancing knowledge and science around an often overlooked driver of hypertension and cardiovascular and kidney disease: aldosterone.1,2
This website provides the latest scientific insights and educational resources, curated by a network of experts, and is intended for healthcare professionals.
Are you a healthcare professional?
