Regulation of the renin-angiotensin system in coronary atherosclerosis: a review of the literature
- PMID: 18200812
- PMCID: PMC2350139
Regulation of the renin-angiotensin system in coronary atherosclerosis: a review of the literature
Abstract
Activation of the renin-angiotensin system (RAS) is significant in the pathogenesis of cardiovascular disease and specifically coronary atherosclerosis. There is strong evidence that the RAS has effects on the mechanisms of action of atherosclerosis, including fibrinolytic balance, endothelial function, and plaque stability. Pharmacological inhibition of the renin angiotensin system includes angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and renin inhibitors. These agents have clinical benefits in reducing morbidity and mortality in the management of hypertension. In addition, ACE inhibitors and ARBs have shown to be effective in the management of congestive heart failure and acute myocardial infarction. This review article discusses the biochemical and molecular mechanisms involving the RAS in coronary atherosclerosis as well as the effects of RAS inhibition in clinical studies involving coronary atherosclerosis.
Similar articles
-
RAS blockade with ARB and ACE inhibitors: current perspective on rationale and patient selection.Clin Res Cardiol. 2008 Jul;97(7):418-31. doi: 10.1007/s00392-008-0668-3. Epub 2008 May 3. Clin Res Cardiol. 2008. PMID: 18454336 Review.
-
Modulating atherosclerosis through inhibition or blockade of angiotensin.Clin Cardiol. 2003 Jul;26(7):305-11. doi: 10.1002/clc.4950260703. Clin Cardiol. 2003. PMID: 12862295 Free PMC article. Review.
-
Pharmacologic blockade of the renin-angiotensin system: vascular benefits beyond commonly understood pharmacologic actions.Pharmacotherapy. 2003 Sep;23(9):1141-52. doi: 10.1592/phco.23.10.1141.32763. Pharmacotherapy. 2003. PMID: 14524646 Review.
-
Effects of renin-angiotensin system inhibition on end-organ protection: can we do better?Clin Ther. 2007 Sep;29(9):1803-24. doi: 10.1016/j.clinthera.2007.09.019. Clin Ther. 2007. PMID: 18035185 Review.
-
Role of the Renin-Angiotensin-Aldosterone System and Its Pharmacological Inhibitors in Cardiovascular Diseases: Complex and Critical Issues.High Blood Press Cardiovasc Prev. 2015 Dec;22(4):429-44. doi: 10.1007/s40292-015-0120-5. Epub 2015 Sep 24. High Blood Press Cardiovasc Prev. 2015. PMID: 26403596 Review.
Cited by
-
Effect of renin angiotensin system inhibitors on long-term major cardiovascular outcomes in patients with high atherosclerotic cardiovascular risk.Sci Rep. 2023 Dec 27;13(1):23066. doi: 10.1038/s41598-023-50430-8. Sci Rep. 2023. PMID: 38155206 Free PMC article.
-
Pharmacologic Management of Heart Failure with Preserved Ejection Fraction (HFpEF) in Older Adults.Drugs Aging. 2025 Feb;42(2):95-110. doi: 10.1007/s40266-024-01165-2. Epub 2025 Jan 18. Drugs Aging. 2025. PMID: 39826050 Review.
-
Reporting on sex-based analysis in clinical trials of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker efficacy.Can J Cardiol. 2008 Jun;24(6):491-6. doi: 10.1016/s0828-282x(08)70624-x. Can J Cardiol. 2008. PMID: 18548147 Free PMC article.
-
The Effects of Different Classes of Antihypertensive Drugs on Patients with COVID-19 and Hypertension: A Mini-Review.Int J Hypertens. 2022 Jan 21;2022:5937802. doi: 10.1155/2022/5937802. eCollection 2022. Int J Hypertens. 2022. PMID: 35075396 Free PMC article. Review.
-
Optimal therapeutic strategy for treating patients with hypertension and atherosclerosis: focus on olmesartan medoxomil.Vasc Health Risk Manag. 2011;7:405-16. doi: 10.2147/VHRM.S20737. Epub 2011 Jun 24. Vasc Health Risk Manag. 2011. PMID: 21796255 Free PMC article. Review.
References
-
- [ALLHAT] The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) JAMA. 2002;288:2981–97. - PubMed
-
- Al-Mallah M, Tleyjeh I, Abdel-Latif A, et al. Angiotensin-converting enzyme inhibitors in coronary artery disease and preserved left ventricular systolic function. J Am Coll Cardiol. 2006;47:1576–83. - PubMed
-
- Andersen S, Schalkwijk CG, Stehouwer CD, et al. Angiotensin II blockade is associated with decreased plasma leukocyte adhesion molecule levels in diabetic nephropathy. Diabetes Care. 2000;23:1031–2. - PubMed
-
- Collins R, Peto R, MacMahon S, et al. Blood pressure stroke and coronary heart disease. Short-term reductions in blood pressure: overview of randomized drug trials in their epidemiological context. Lancet. 1990;335:827–38. - PubMed
-
- Cushman DW, Wang FL, Fung WC, et al. Differentiation of angiotensin converting enzyme inhibitors (ACE) by their selective inhibition of ACE in physiologically important target organs. Am J Hypertens. 1989;2:294–306. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous