Inhibition of the renin angiotensin system: implications for the endothelium.
The endothelium is critically involved in modulating vascular tone through the release of vasodilator (mainly nitric oxide; NO) and vasoconstrictor agents. Under normal conditions the endothelium induces NO-mediated vasodilation, and opposes cell adhesion and thrombosis. Angiotensin II-induced generation of reactive oxygen species plays a key role in the pathophysiology of endothelial dysfunction by reducing NO bioavailability. Endothelial dysfunction is associated with several pathologic conditions, including hypertension and diabetes, and is characterized by altered vascular tone, inflammation, and thrombosis in the vascular wall. Inhibition of the renin-angiotensin-aldosterone system has induced beneficial effects on endothelial function in animals and humans. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and mineralocorticoid receptor antagonists have improved endothelial function in hypertension and diabetes, slowed the progression of atherosclerosis, and reduced the risk associated with cardiovascular disease.
Savoia
Carmine
C
Lady Davis Institute for Medical Research, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada H3T 1E2.
Schiffrin
Ernesto L
EL
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D018161:Receptors, Mineralocorticoid / Q000502:physiology; D012084:Renin-Angiotensin System; D014661:Vasoconstriction; D014662:Vasoconstrictor Agents; D014664:Vasodilation; D014665:Vasodilator Agents
D000806:Angiotensin-Converting Enzyme Inhibitors; D018161:Receptors, Mineralocorticoid; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents