REN and heart failure: Therefore, aldosterone has a critical role in the pathogenesis of hypertension-associated LVH; it has also been suggested that the effects of aldosterone with regards to the pathogenesis of hypertensive heart disease and heart failure are independent of renin and angiotensin-II because the administration of an aldosterone receptor antagonist, Aldactone, in combination with other standard heart failure medications markedly improved the outcomes in individuals with severe heart failure [27].