Aldosterone, a vital hormone of the human body, has various pathophysiological roles. The excess of aldosterone, also known as primary aldosteronism, is the most common secondary cause of hypertension. Primary aldosteronism is associated with an increased risk of cardiovascular disease and kidney dysfunction compared to essential hypertension. Excess aldosterone can lead to harmful metabolic and other pathophysiological alterations, as well as cause inflammatory, oxidative, and fibrotic effects in the heart, kidney, and blood vessels. These alterations can result in coronary artery disease, including ischemia and myocardial infarction, left ventricular hypertrophy, heart failure, arterial fibrillation, intracarotid intima thickening, cerebrovascular disease, and chronic kidney disease. Thus, aldosterone affects several tissues, especially in the cardiovascular system, and the metabolic and pathophysiological alterations are related to severe diseases. Therefore, understanding the effects of aldosterone on the body is important for health maintenance in hypertensive patients. In this review, we focus on currently available evidence regarding the role of aldosterone in alterations of the cardiovascular and renal systems. We also describe the risk of cardiovascular events and renal dysfunction in hyperaldosteronism.

A 76-year-old man presented with fever, and pain in his right ear. Physical examination revealed tender edematous, erythema, and a few vesicles of the right ear, along with facial involvement (Picture 1, 2). Laboratory examination showed neutrophilic leukocytosis. The next day, his left ear and face showed a tender light-colored erythema (Picture 3). After treatment with intravenous ceftriaxone, his symptoms fully resolved. Serum IgM using an enzyme immunoassay for both varicella-zoster virus and herpes simplex virus was negative. Finally, a clinical diagnosis of bilateral ear erysipelas was made. Erysipelas is a common infection involving the upper dermis and lymphatics, whereas cellulitis involves the deeper dermis and subcutaneous fat (1). Ear involvement is called Milian's ear sign, and it is a feature distinguishing erysipelas from cellulitis, because the pinna has no deeper dermis and subcutaneous tissue (2). Bilateral ear erysipelas is rare, but it should be considered in the differential diagnosis when encountering patients presenting with red ears. The authors state that they have no Conflict of Interest (COI).