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Pathophysiology of target-organ disease: does angiotensin II remain the key?

Ronald G Victor1

  • 1Hypertension Division, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390-8586, USA. ronald.victor@utsouthwestern.edu

Journal of Clinical Hypertension (Greenwich, Conn.)
|November 21, 2007
PubMed

Insights

Renin-angiotensin system (RAS) blockade shows promise for hypertension and cardiovascular risk. Further research into complete RAS blockade is needed for better target-organ protection.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Hypertension Research

Background:

  • The renin-angiotensin system (RAS) plays a crucial role in hypertension and cardiovascular disease.
  • Current RAS blockade strategies, including ACE inhibitors and ARBs, have shown variable results.
  • Incomplete blockade may limit the blood pressure-independent benefits of RAS inhibitors.

Purpose of the Study:

  • To explore the rationale for RAS blockade in hypertension and cardiovascular risk reduction.
  • To investigate the complexity of RAS pathways in target-organ damage.
  • To evaluate the potential of complete RAS blockade for cardiovascular target-organ protection.

Main Methods:

  • Review of basic research findings on RAS pathways.
  • Analysis of clinical trial outcomes for ACE inhibitors and ARBs.
  • Examination of animal studies on RAS and target-organ damage.
  • Consideration of ongoing outcomes trials for complete RAS blockade.

Main Results:

  • Basic research supports RAS blockade for hypertension and cardiovascular risk reduction.
  • Clinical trials show mixed results, potentially due to incomplete RAS blockade.
  • Animal studies reveal complex RAS pathways contributing to target-organ damage.

Conclusions:

  • Complete RAS blockade holds potential for enhanced cardiovascular target-organ protection.
  • Further clinical trials are necessary to fully understand the benefits of comprehensive RAS blockade.
  • Optimizing RAS blockade strategies is key to improving cardiovascular outcomes.

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