White matter lesions (WMLs) in the brain are mostly caused by cerebral small vessel disease linked to traditional cardiovascular risk factors, which increase the risk of dementia, depression, stroke occurrence, and death [1]. Hypertension is a significant risk factor leading to WMLs [2]. In hypertensive patients, approximately 5% to 13% of patients have increased secretion of excessive aldosterone (ALD) and activation of the mineralocorticoid receptor (MR). To date, we have proven that a higher plasma aldosterone concentration (PAC) increases the risk of WMLs, and PAC is positively associated with white matter lesion load independent of blood pressure (BP) levels [3].
