Aldosterone plays an important role in the regulation of electrolyte and water homeostasis and in blood pressure maintenance. The latest studies have revealed involvement of this hormone in the development of myocardium hypertrophy and fibrosis, with heart failure progression, vessel remodeling, and atherogenesis. The crucial enzyme in aldosterone production is aldosterone synthase, which catalyses the last three steps of its synthesis. It was reported in many studies that polymorphisms of the gene encoding aldosterone synthase, CYP11B2, especially the -344C/T polymorphism, are associated with cardiovascular diseases. This article is a short review of research on the role of the CYP11B2-344C/T polymorphism in hypertension, heart muscle remodeling, and especially in atherogenesis. Information about the molecular basis of aldosterone's synthesis, action, and significance, especially in heart failure, is also provided.