[Inflammation and atherosclerosis: the role of Renin-Angiotensin system and its inhibition]

Area of Science:

• Cardiovascular Science
• Renal Physiology
• Inflammation Biology

Context:

• Atherosclerosis involves complex inflammatory processes contributing to plaque development and cardiovascular events.
• The renin-angiotensin-aldosterone system (RAAS) is implicated in regulating blood pressure and fluid balance.
• Emerging evidence highlights the RAAS's role beyond hemodynamics, particularly in vascular inflammation.

Purpose:

• To review the role of the renin-angiotensin-aldosterone system in vascular inflammation during atherosclerosis.
• To summarize the mechanisms by which angiotensin II promotes atherosclerotic processes.
• To discuss the therapeutic implications of targeting the RAAS in cardiovascular diseases.

Summary:

• The renin-angiotensin-aldosterone system, especially angiotensin II, promotes atherosclerosis through vasoconstriction, sodium/water retention, and inflammation.
• Angiotensin II acts as a mediator of inflammation, inducing cytokine and chemokine secretion, leading to endothelial dysfunction, plaque development, and cardiac remodeling.
• Pharmacological inhibition of the RAAS (ACE inhibitors, ARAs, renin inhibitors) demonstrates clinical benefits in cardiovascular diseases, independent of blood pressure reduction.

Impact:

• Understanding the inflammatory role of the RAAS provides novel therapeutic targets for atherosclerosis.
• Targeting the RAAS offers a strategy to mitigate vascular inflammation and improve cardiovascular outcomes.
• This review consolidates current knowledge on RAAS inhibitors' effects on vascular inflammation in atherosclerosis, guiding future research and clinical practice.