Related Experiment Video

Updated: Aug 18, 2025

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
08:21

A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Published on: October 26, 2020

4.9K

Renin-Angiotensin System-Modifying Antihypertensive Drugs Can Reduce the Risk of Cardiovascular Complications in

Chelsie Hurst1, Maira Soto1, Ernest R Vina2

  • 1Department of Pharmacology, Center for Innovation in Brain Science, College of Medicine, University of Arizona, Tucson.

The American Journal of Medicine
|December 10, 2022
PubMed

Insights

Renin-angiotensin system (RAS) drugs significantly lower cardiovascular disease risk in patients with systemic lupus erythematosus. These findings support RAS-modifying therapies for hypertension management in lupus patients.

Area of Science:

  • Cardiology
  • Rheumatology
  • Pharmacology

Background:

  • Patients with systemic lupus erythematosus (SLE) face a higher risk of cardiovascular disease (CVD) compared to the general population.
  • Antihypertensive drugs targeting the renin-angiotensin system (RAS) are crucial for managing lupus nephritis and may offer additional cardiovascular benefits through anti-inflammatory effects.
  • This study investigates the comparative impact of RAS-modifying versus non-RAS antihypertensive drugs on CVD incidence in SLE patients.

Purpose of the Study:

  • To compare the incidence of cardiovascular disease in patients with systemic lupus erythematosus treated with renin-angiotensin system (RAS) modifying drugs versus non-RAS drugs.
  • To evaluate the potential of RAS-modifying therapies to mitigate cardiovascular risk in SLE patients, considering their renal and extrarenal effects.

Main Methods:

  • A large medical insurance claims dataset was utilized, identifying 220,168 patients with lupus.
  • A cohort of 31,647 eligible patients (4,018 on RAS drugs, 27,629 on non-RAS drugs) was selected, with propensity score matching applied to balance demographic data, risk factors, and comorbidities.
  • The mean age of patients was 46.1 years, with 93.0% being female and 96.9% having a Charlson Comorbidity Index score of 0-4, indicating a generally healthy cohort.

Main Results:

  • RAS-modifying drugs were associated with a reduced relative risk (RR) of cardiovascular disease diagnosis (RR 0.80; 95% CI, 0.74-0.87), with a more pronounced effect after propensity score matching (RR 0.62; 95% CI, 0.57-0.68).
  • This risk reduction was consistent across patients with and without lupus nephritis.
  • RAS-modifying therapies significantly improved 5-year cardiovascular disease-free survival probability (86.0% vs 78.3%).

Conclusions:

  • Renin-angiotensin system (RAS)-modifying drugs demonstrate a significant reduction in cardiovascular disease risk among patients with systemic lupus erythematosus.
  • These findings suggest that RAS-modifying therapies are a valuable option for hypertension management in SLE patients, potentially impacting clinical decision-making.
  • The study highlights the dual benefit of RAS-modifying drugs in managing both renal and cardiovascular complications in SLE.
Abstract

Keywords:
ACE inhibitors (ACE-I)Angiotensin receptor blockers (ARB)Cardiovascular diseaseInsurance claims databaseRenin-angiotensin system (RAS)Retrospective cohort studySystemic lupus erythematosus

More Related Videos

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

3.4K
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice09:43

Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice

Published on: June 8, 2022

3.0K

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

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...
482
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
737
Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors01:30

Antihypertensive Drugs: Angiotensin-Converting Enzyme Inhibitors

Angiotensin-converting enzyme (ACE), a vital component of the renin-angiotensin-aldosterone system, is abundant in lung endothelial cells. ACE converts the inactive decapeptide, angiotensin I, into the active octapeptide, angiotensin II. This potent vasoconstrictor narrows blood vessels, increasing resistance to blood flow and elevating blood pressure. Angiotensin II also stimulates aldosterone production, encouraging kidney cells to reabsorb more sodium and water from urine, thereby increasing...
755
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

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...
448
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
809
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

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,...
35