Summary schematic of aldosterone's contribution to fibrosis and inflammation in diabetes over time. Excess aldosterone production occurring in diseases such as essential hypertension, primary aldosteronism, diabetes, and obesity contributes to increased blood pressure. Over time, elevated blood pressure and/or aldosterone cause renal and vascular injury, which activates the innate and adaptive immune systems, causing further tissue injury and thereafter exacerbating the detrimental effects of the initial disease. ATP, adenosine triphosphate; DAMP, damage-associated molecular pattern; DC, dendritic cell; IFN, interferon; IL, interleukin; MΦ, macrophage; Ne, neutrophil; ROS, reactive oxygen species; Tc, cytotoxic T cells; TGF, transforming growth factor; Th, T-helper cells; TNF, tumor necrosis factor; Treg, T regulatory cells. Reprinted with permission from Ferreira NS, Tostes RC, Paradis P, Schiffrin E. Am J Hypertens 2021;34:15–27.