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Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...

Hormonal Regulation

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The renin-aldosterone system is an endocrine system which guides the renal absorption of water and electrolytes, thus managing blood pressure and osmoregulation. Activation of the system begins in the kidneys with a small cluster of cells adjacent to the afferent and efferent blood vessels of the renal corpuscle. As the nephrons are filtering blood, juxtaglomerular cells monitor blood pressure. If they detect a decrease in pressure, they release the hormone renin into the bloodstream.

Hypertension II: Pathophysiology

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Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...

Hypertension and Regulation of Blood Pressure

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Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...

Heart Failure II: Pathophysiology

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...

Heart Failure Drugs: Diuretics

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Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...

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Related Experiment Video

Updated: Sep 27, 2025

Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice

Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice

Published on: September 26, 2018

Aldosterone and cardiovascular diseases.

Wasita W Parksook^1,2,3, Gordon H Williams¹

¹Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Cardiovascular Research

|April 7, 2022

Summary

Aldosterone and its receptor (MR) are linked to heart failure, atrial fibrillation, and myocardial infarction. More research is needed to understand their roles in atherosclerosis, stroke, and thrombosis.

Keywords:

Aldosterone Atherosclerosis Atrial fibrillation Cardiovascular Heart failure Mineralocorticoid receptor Myocardial infarction Stroke Thrombosis

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Induction of Atherosclerotic Plaques Through Activation of Mineralocorticoid Receptors in Apolipoprotein E-deficient Mice

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Published on: September 26, 2018

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Published on: June 7, 2016

A Mouse 5/6th Nephrectomy Model That Induces Experimental Uremic Cardiomyopathy

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Area of Science:

Cardiovascular Medicine
Endocrinology
Pharmacology

Background:

Aldosterone's role in kidney function and hypertension is established.
The involvement of aldosterone and the mineralocorticoid receptor (MR) in other cardiovascular diseases remains less understood.
Investigating these roles is crucial for developing new therapeutic strategies.

Approach:

Systematic review of literature from January 2011 to June 2021.
Assessed mechanistic studies, pre-clinical data, clinical trials of MR antagonists, and genetic associations.
Included 200 publications from an initial search of 3702 articles.

Key Points:

Strong evidence links dysregulated aldosterone/MR to heart failure.
Moderate associations were found between aldosterone/MR and atrial fibrillation and myocardial infarction.
Insufficient data currently exists to confirm aldosterone/MR's role in atherosclerosis, stroke, or thrombosis.

Conclusions:

Aldosterone/MR dysregulation plays a significant role in cardiovascular diseases beyond hypertension.
Further research is needed to fully elucidate these relationships and explore MR modulators for treatment.
Expanding the understanding of aldosterone/MR pathways may lead to novel therapeutic targets for cardiovascular conditions.