scholarly journals New Perspectives in the Renin-Angiotensin-Aldosterone System (RAAS) III: Endogenous Inhibition of Angiotensin Converting Enzyme (ACE) Provides Protection against Cardiovascular Diseases

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e93719 ◽  
Author(s):  
Miklós Fagyas ◽  
Katalin Úri ◽  
Ivetta M. Siket ◽  
Andrea Daragó ◽  
Judit Boczán ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
Angiotensin Converting Enzyme ◽  
Converting Enzyme ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin

scholarly journals Clinical outcome of renin-angiotensin-aldosterone system blockers in treatment of hypertensive patients with COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 73 (1) ◽  
Author(s):  
Andrea Laurentius ◽  
Brian Mendel ◽  
Radityo Prakoso
Keyword(s):  
Clinical Outcome ◽  
Angiotensin Converting Enzyme ◽  
Angiotensin Receptor Blockers ◽  
Hospital Treatment ◽  
Main Body ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Renin Angiotensin Aldosterone System ◽  
Hypertensive Patients ◽  
Renin Angiotensin

Abstract Background Novel coronavirus disease 2019 has been stated as global disease pandemic due to its rapid spread worldwide. Up to 30% of coronavirus disease 2019 patients with hypertension are more susceptible to death. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been used as primary line of medication for hypertension; nonetheless, conflicting data arises as numerous studies showed contradictory results. Main body Aiming to show clinical outcome of renin-angiotensin-aldosterone system blockers in hospital treatment of hypertensive patients with coronavirus disease 2019, systematically searched literatures through five databases were intensively appraised using The Grading of Recommendations Assessment, Development and Evaluation checklists for cohort studies. Based on the result evaluation from retrospective cohorts involving more than 15,000 patients across Asia and other regions of the world, ten encompassed studies divided into two subgroups in this meta-review showed that in-hospital hypertensive coronavirus disease 2019 patients receiving antihypertensive drugs were associated with overall risk reduction in subgroup 1 (hazard ratio, HR = 0.96, 95% CI = 0.82–1.12) to no outcome association of all-cause mortalities in subgroup 2 (HR = 0.26, 95% CI = 0.19–0.34). All appraised studies in synergism showed that mortality outcomes were not augmented with the employment of either ACE inhibitor or ARB in subjects. Conclusion Therefore, the results support recommendation by the American Heart Association not to discontinue angiotensin-converting enzyme inhibitor or angiotensin receptor blocker regimens in coronavirus disease 2019 patients with hypertension.

scholarly journals Renin-angiotensin-aldosterone system inhibitors – a realm of confusion in COVID-19

2021 ◽  
Vol 4 (Special2) ◽  
pp. 389-394
Author(s):  
Angela Madalina Lazar
Keyword(s):  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Current Knowledge ◽  
Angiotensin Receptor Blockers ◽  
Protective Effects ◽  
Converting Enzyme ◽  
Angiotensin I ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Inhibitors

Currently, there is a persisting dispute regarding the renin-angiotensin-aldosterone-system (RAAS) inhibitors' safety of use in COVID-19 pandemics. On one side, RAAS inhibitors appear to determine an overexpression of ACE2, the receptor of SARS-CoV-2. Therefore, they could increase the risk of SARS-CoV-2 infection and its degree of severity. On the other side, the discontinuation of RAAS leads to cardiovascular decompensation and has been discouraged by the major medical societies. Also, large-cohort studies report beneficial or at least neutral effects for the RAAS inhibitors in COVID-19 patients. Worldwide, millions of patients receive RAAS inhibitors for the treatment of hypertension and other important comorbidities. In this context, knowledge of the exact effect of these medications becomes of crucial significance. This paper aims to fill in a gap in the current knowledge and presents a putative mechanism by which RAAS inhibitor administration's beneficial results can be explained better. RAAS inhibitors can be beneficial, as they counteract the excessive detrimental activation of the classical angiotensin-converting enzyme (ACE) axis, decreasing the angiotensin II levels. The angiotensin receptor blockers (ARBs) increase the angiotensin II levels, while the angiotensin-converting enzyme inhibitors (ACEI) increase the angiotensin I levels; these substrates will compete with the SARS-CoV-2 for the ACE2 binding, decreasing the viral infectivity. In addition, following the RAAS inhibitors treatment, the up-regulated ACE2 will cleave these substrates (angiotensin I and II), particularly to angiotensin 1-7 that possesses vasodilator, protective effects.

scholarly journals Advances in the Renin-Angiotensin-Aldosterone System: Relevance to Diabetic Nephropathy

2008 ◽  
Vol 8 ◽  
pp. 434-445 ◽  
Author(s):  
Audrey Koitka ◽  
Christos Tikellis
Keyword(s):  
Diabetic Nephropathy ◽  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Renal Disease ◽  
Converting Enzyme ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Angiotensin Type 2 Receptor

Hypertension is now recognized as a key contributory factor to the development and progression of kidney disease in both type 1 and type 2 diabetes. The renin angiotensin system (RAS) and its effector molecule angiotensin II, in particular, have a range of hemodynamic and nonhemodynamic effects that contribute not only to the development of hypertension, but also to renal disease. As a result, therapeutic inhibition of the RAS with angiotensin-converting enzyme inhibitors and/or selective angiotensin II type 1 receptor blockers has been proposed as a key strategy for reducing kidney damage beyond the expected effects one would observe with blood pressure reduction per se. Although the relationship between the RAS and the progression of diabetic renal disease has been known for many decades, recent advances have revealed a more complex paradigm with the discovery of a number of new components. Thus, further understanding of these new components of the renin angiotensin aldosterone system (RAAS), such as the angiotensin type 2 receptor subtype, angiotensin converting enzyme 2, and the recently cloned renin receptor, is likely to have therapeutic implications for disorders such as diabetic nephropathy, where interruption of the RAAS is widely used.

scholarly journals New Perspectives in the Renin-Angiotensin-Aldosterone System (RAAS) I: Endogenous Angiotensin Converting Enzyme (ACE) Inhibition

PLoS ONE ◽  
2014 ◽  
Vol 9 (4) ◽  
pp. e87843 ◽  
Author(s):  
Miklós Fagyas ◽  
Katalin Úri ◽  
Ivetta M. Siket ◽  
Andrea Daragó ◽  
Judit Boczán ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Ace Inhibition ◽  
Converting Enzyme ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin

scholarly journals Is hypertension in African-descent populations contributed to by an imbalance in the activities of the ACE2/Ang-(1-7)/Mas and the ACE/Ang II/AT1 axes?

2020 ◽  
Vol 21 (1) ◽  
pp. 147032032090818 ◽  
Author(s):  
Damian Cohall ◽  
Nkemcho Ojeh ◽  
Carlos M Ferrario ◽  
O Peter Adams ◽  
Marcella Nunez-Smith
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Chronic Renal Disease ◽  
African Descent ◽  
Venous Blood ◽  
Plasma Renin ◽  
Converting Enzyme ◽  
Renin Angiotensin Aldosterone System ◽  
Angiotensin Converting Enzyme 2 ◽  
Renin Angiotensin ◽  
Mas Receptor

Introduction: Low plasma renin activity hypertension is prevalent in Afro-Caribbean persons. Reduced angiotensin converting enzyme 2 activity from the counter angiotensin converting enzyme 2 /angiotensin-(1-7)/Mas receptor axis of the renin angiotensin aldosterone system has been reported in people with pre-hypertension, type 2 diabetes mellitus and chronic renal disease. This study investigates whether an imbalance in the regulatory mechanisms between the pressor arm of the renin angiotensin aldosterone system (angiotensin converting enzyme/angiotensin II/AT1 receptor) and the depressor axis (angiotensin converting enzyme 2/angiotensin-(1-7)/Mas receptor) predisposes persons of African descent to hypertension. Methods: In total, 30 normotensives and 30 recently diagnosed hypertensives aged 18–55 of Afro-Caribbean origin who are naïve to antihypertensive treatment will be recruited from public sector polyclinics in Barbados. Demographic and anthropometric data, clinical blood pressure readings, 24-hour urine collections and venous blood samples will be collected. Biological samples will be analysed for renin angiotensin aldosterone system peptide markers using radioimmunoassay. Conclusion: We describe the design, methods and rationale for the characterization of renin angiotensin aldosterone system mechanisms that may contribute to hypertension predisposition in persons of African descent. Our findings will characterize any imbalance in the counter axes of the renin angiotensin aldosterone system in hypertensive Afro-Caribbeans with a potential view of identifying novel approaches with the use of renin angiotensin aldosterone system and mineralocorticoid blockers to manage the condition.

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