Figure 1
From: From aldosteronism to oxidative stress: the role of excessive intracellular calcium accumulation

Major and minor stimuli to aldosterone production by zona glomerulosa cells of the adrenal glands. Major stimuli include renin-dependent angiotensin II formation and increased extracellular or plasma K+ concentrations. Minor stimuli include adrenocorticotropin hormone (ACTH) and catecholamines derived through an activation of the hypothalamic-pituitary-adrenal (HPA) axis in response to a stressor state. Catecholamine-mediated intracellular Ca2+ overloading and augmented Ca2+ excretion each contribute to the appearance of ionized hypocalcemia. In turn, hypocalcemia promotes secondary hyperparathyroidism with elevated circulating levels of parathyroid hormone (PTH). This calcitropic hormone also leads to intracellular Ca2+ overloading of diverse tissues, including cardiomyocytes and their mitochondria, with an induction of oxidative stress.