Interactions between the renin-angiotensin system and dyslipidemia: relevance in the therapy of hypertension and coronary heart disease.
Dyslipidemia and hypertension are frequently observed in patients with ischemic heart disease. Studies from a number of laboratories suggest up-regulation of different components of the renin-angiotensin system (RAS) in patients with hypertension and atherosclerosis. Lipid accumulation in the blood vessels enhances the expression of RAS components; on the other hand, activation of RAS stimulates accumulation of low-density lipoproteins, particularly the oxidatively modified form, in the blood vessels. This concept of cross-talk between dyslipidemia and RAS activation has been proven in laboratory-based studies. Clinical trials also suggest that blockade of dyslipidemia and RAS may have a synergistic salutary effect on the outcome of patients with hypertension and/or manifestations of atherosclerosis. This concept needs to be evaluated in large clinical studies.
Singh
Balkrishna M
BM
Division of Cardiovascular Medicine, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, USA.
Mehta
Jawahar L
JL
D000804:Angiotensin II / Q000378:metabolism; D000818:Animals; D002784:Cholesterol / Q000096:biosynthesis; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000503:physiopathology*; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D008077:Lipoproteins, LDL / Q000378:metabolism; D010084:Oxidation-Reduction; D017382:Reactive Oxygen Species / Q000378:metabolism; D012084:Renin-Angiotensin System / Q000502:physiology*
D008077:Lipoproteins, LDL; D017382:Reactive Oxygen Species; C099252:oxidized low density lipoprotein; D000804:Angiotensin II; D002784:Cholesterol