Role of renal and extrarenal renin-angiotensin system in the mechanism of arterial hypertension and its sequelae.
The role of the renin-angiotensin system in cardiovascular function and disease has long been recognized. The renin-angiotensin system was originally thought to be only active in the plasma as a circulating endocrine system, controlling blood pressure and electrolyte homeostasis. The recent introduction of new biotechnologies to cardiovascular research has demonstrated that the renin-angiotensin system can operate as both an endocrine (circulating) and an autocrine/paracrine (tissue) system. The endocrine component is involved with acute circulating homeostasis, whereas it is believed that the tissue renin-angiotensin system participates in the tonic regulation of cardiovascular function and structure. Multiple lines of evidence support the presence of complete renin-angiotensin systems in the central nervous system, vasculature, adrenal, heart, kidney, and reproductive organs. Although more research is necessary to delineate the role of tissue renin-angiotensin systems in local tissue function, the significant contribution of the renin-angiotensin system in the pathophysiology of cardiovascular disease is increasingly apparent (Table 1).
Rosenthal
J
J
Section Pharmacotherapy, Ulm University Medical Center, Germany.
D000311:Adrenal Glands / Q000503:physiopathology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000818:Animals; D001808:Blood Vessels / Q000503:physiopathology; D002490:Central Nervous System / Q000503:physiopathology; D006321:Heart / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology*; D012084:Renin-Angiotensin System; D014566:Urogenital System / Q000503:physiopathology
D000806:Angiotensin-Converting Enzyme Inhibitors