title: Interactions between the renin-angiotensin system and dyslipidemia: relevance in atherogenesis and therapy of coronary heart disease.
abstract: Hypertension and hypercholesterolemia, two major risk factors for atherosclerotic disease, frequently coexist in patients with hypertension and CAD. Data from clinical studies suggest the existence of lipoprotein-neurohormonal interactions that may adversely affect vascular structure and reactivity. Data from preclinical studies suggest that RAS may be upregulated by abnormal lipids, most likely via production of ox-LDL. On the other hand, activation of RAS leads to release of ROS and transcriptional upregulation of LDL and ox-LDL uptake in macrophages, smooth muscle cells and endothelial cells. These findings extend our understanding of the interplay among risk factors to synergistically increase cardiovascular risk, and of the anti-atherosclerotic effects of local ACE inhibition to reduce cardiovascular risk. Trials aimed at modifying RAS along with drugs lowering total- and LDL-cholesterol levels and inhibitors of oxidative modification of LDL-cholesterol will address the clinical relevance of this biological interaction.
authors.affiliation: Department of Internal Medicine, University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System, Little Rock 72205, USA.
authors.forename: B K
authors.initials: BK
authors.lastname: Singh
authors.forename: J L
authors.initials: JL
authors.lastname: Mehta
mesh_terms: D000818:Animals; D001161:Arteriosclerosis / Q000503:physiopathology*; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology*; D066298:In Vitro Techniques; D011817:Rabbits; D012084:Renin-Angiotensin System / Q000502:physiology*