Role of the tissue renin-angiotensin system in vascular remodeling and smooth muscle cell growth.
In recent years numerous data have given evidence that the tissue renin-angiotensin system may play an equal or perhaps an even more important role than the circulating renin-angiotensin system in numerous physiologic processes. This was first suggested by the observation that the blood pressure lowering effect of angiotension-converting enzyme (ACE) inhibitors correlates better with tissue ACE activity than with plasma ACE activity. In response to hypertension and arterial injury, vascular smooth muscle cells undergo three responses: hypertrophy, hyperplasia, and remodeling. The end result is a decrease in lumen diameter and an increase in peripheral vascular resistance. Blockade of angiotensin II formation inhibits these smooth muscle responses in a number of animal models. This review discusses the evidence supporting the existence of local tissue renin-angiotensin system in the vasculature and its physiologic effects. Inhibition of the vascular renin-angiotensin system may have important implications in the treatment of patients with hypertension, atherosclerosis, and restenosis following balloon coronary angioplasty.
Vanderbilt University School of Medicine, Division of Cardiology, Nashville, TN 37232-2170.
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D000818:Animals; D002455:Cell Division; D006133:Growth Substances / Q000502:physiology; D006801:Humans; D009131:Muscle, Smooth, Vascular / Q000166:cytology / Q000201:enzymology / Q000378:metabolism*; D012084:Renin-Angiotensin System / Q000502:physiology*
D006133:Growth Substances