Recent Advances in the Knowledge of Naturally-derived Bioactive Compounds as Modulating Agents of the Renin-angiotensin-aldosterone System: Therapeutic Benefits in Cardiovascular Diseases

2019 ◽  
Vol 25 (6) ◽  
pp. 670-684 ◽  
Author(s):  
Priscila de Souza ◽  
Luisa M. da Silva ◽  
Sérgio F. de Andrade ◽  
Arquimedes Gasparotto Junior
Keyword(s):  
Cardiovascular Diseases ◽  
Bioactive Compounds ◽  
Current Therapy ◽  
Renal Diseases ◽  
Attractive Alternative ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Blockade ◽  
Therapeutic Benefits ◽  
Cardiovascular Morbidity And Mortality

Background: One of the biggest challenges to public health worldwide is to reduce the number of events and deaths related to the cardiovascular diseases. Numerous approaches have been applied to reach this goal, and drug treatment intervention has been indispensable along with an effective strategy for reducing both cardiovascular morbidity and mortality. Renin-angiotensin-aldosterone system (RAAS) blockade is currently one of the most important targets of cardiovascular drug therapy. Many studies have proven the valuable properties of naturally-derived bioactive compounds to treat cardiovascular diseases. Methods: The goal of this review, therefore, is to discuss the recent developments related to medicinal properties about natural compounds as modulating agents of the RAAS, which have made them an attractive alternative to be available to supplement the current therapy options. Results: Data has shown that bioactive compounds isolated from several natural products act either by inhibiting the angiotensin-converting enzyme or directly by modulating the AT1 receptors of angiotensin II, which consequently changes the entire classical axis of this system. Conclusion: While there are a few evidence about the positive actions of different classes of secondary metabolites for the treatment of cardiovascular and renal diseases, data is scarce about the clinical assays established to demonstrate their value in humans.

scholarly journals Tactics of antihypertensive therapy during COVID-19 pandemic

2021 ◽  
Vol 93 (9) ◽  
pp. 1125-1131
Author(s):  
Valery I. Podzolkov ◽  
Anna Е. Bragina ◽  
Yulia N. Rodionova ◽  
Galina I. Bragina ◽  
Ekaterina E. Bykova
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Arterial Hypertension ◽  
Ace Inhibitor ◽  
Fixed Combination ◽  
Significant Risk ◽  
Effective Control ◽  
Combination Drug ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin

Results of foreign and Russian studies indicate a higher mortality rate of patients with concomitant cardiovascular diseases (CVD) due to the new coronavirus infection COVID-19. It has been proven that arterial hypertension, as one of the significant risk factors for the development of concomitant cardiovascular diseases, is associated with a more severe prognosis of COVID-19. This article presents the results of modern studies and large meta-analyzes of necessity and safety of the use of blockers of the renin-angiotensin-aldosterone system in patients with arterial hypertension and COVID-19. The data of studies show that an angiotensin-converting enzyme inhibitor (ACE inhibitor) and a thiazide-like diuretic is a pathogenetically rational combination. It realizes various ways of lowering blood pressure by reducing the activity of the renin-angiotensin-aldosterone system, which is achieved by using an ACE inhibitor, and natriuresis due to diuretics. As an example, a highly effective fixed combination of drugs is considered, characterized by good tolerance, which consists of an ACE inhibitor lisinopril and a thiazide-like diuretic indapamide of prolonged action. The authors expressed the opinion that the appointment of the fixed combination drug Diroton Plus (Gedeon Richter) will contribute to effective control of blood pressure and organoprotection in conditions of increased thrombogenic and prooxidative potential, characteristic of COVID-19 both in the acute stage and within the post-COVID Syndrome.

scholarly journals Review of polymorphisms, associated with cardiovascular diseases

2021 ◽  
pp. 333-338
Author(s):  
A. A. Akopyan ◽  
I. D. Strazhesko ◽  
O. N. Tkacheva ◽  
A. P. Yesakova ◽  
I. A. Orlova
Keyword(s):  
Oxidative Stress ◽  
Nitric Oxide ◽  
Cardiovascular Diseases ◽  
Chronic Inflammation ◽  
Gene Polymorphisms ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
System Activation ◽  
And Oxidative Stress

In this research we examined studies of gene polymorphisms, associated with cardiovascular diseases through renin-angiotensin-aldosterone system activation (AGT с.521С>Т, AСE Ins>Del), nitric oxide decline (NOS3 с.894G>T), chronic inflammation (TNF -238G>A, MMP9 -1562С>T) and oxidative stress (CYBA c.214Т>С).

scholarly journals Role of the Renin-Angiotensin-Aldosterone System in Dystrophin-Deficient Cardiomyopathy

2020 ◽  
Author(s):  
Moises Rodriguez-Gonzalez ◽  
Manuel Lubian-Gutierrez ◽  
Helena Maria Cascales-Poyatos ◽  
Alvaro Antonio Perez-Reviriego ◽  
Ana Castellano-Martinez
Keyword(s):  
Therapeutic Strategy ◽  
Clinical Evidence ◽  
Enzyme Inhibitors ◽  
English Literature ◽  
Current Evidence ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Blockade ◽  
Comprehensive Search

Dystrophin-deficient cardiomyopathy (DDC) is currently the leading cause of death in patients with dystrophinopathies. Targeting myocardial fibrosis (MF) has become a major therapeutic goal in order to prevent the occurrence of DDC. We aimed to review and summarize the current evidence about the role of the renin-angiotensin-aldosterone system (RAAS) in the development and perpetuation of MF in DCC. We conducted a comprehensive search of peer-reviewed English literature on PubMed about this subject. We found increasing preclinical evidence from studies in animal models during the last 20 years pointing out a central role of RAAS in the development of MF in DDC. Local tissue RAAS acts directly mainly through its main fibrotic component angiotensin II (ANG2) and its transducer receptor (AT1R) and downstream TGF-b pathway. Also, it modulates the actions of most of the remaining pro-fibrotic factors involved in DDC. Despite limited clinical evidence, RAAS blockade constitutes the most studied, available and promising therapeutic strategy against MF and DDC. Conclusion: Based on the evidence reviewed, it would be recommendable to start RAAS blockade therapy through angiotensin converter enzyme inhibitors (ACEI) or AT1R blockers (ARBs) alone or in combination with mineralocorticoid receptor antagonists (MRa) at the youngest age after the diagnosis of dystrophinopathies, in order to delay the occurrence or slow the progression of MF, even before the detection of any cardiovascular alteration.

Effect of renin-angiotensin-aldosterone system (RAAS) blockade on visfatin levels in diabetic nephropathy

Nephrology ◽  
2010 ◽  
Vol 15 (2) ◽  
pp. 225-229 ◽  
Author(s):  
TAYFUN EYILETEN ◽  
ALPER SONMEZ ◽  
MUTLU SAGLAM ◽  
ERDINC CAKIR ◽  
KAYSER CAGLAR ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Blockade

scholarly journals Cushing's disease and hypertension: in vivo and in vitro study of the role of the renin-angiotensin-aldosterone system and effects of medical therapy

2014 ◽  
Vol 170 (2) ◽  
pp. 181-191 ◽  
Author(s):  
R van der Pas ◽  
J H M van Esch ◽  
C de Bruin ◽  
A H J Danser ◽  
A M Pereira ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cushing’S Disease ◽  
In Vitro Study ◽  
Cushing's Disease ◽  
Ang Ii ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Raas Blockade

Objective/methodsCushing's disease (CD) is often accompanied by hypertension. CD can be treated surgically and, given the expression of somatostatin subtype 5 and dopamine 2 receptors by corticotroph pituitary adenomas, pharmacologically. Indeed, we recently observed that stepwise medical combination therapy with the somatostatin-analog pasireotide, the dopamine-agonist cabergoline, and ketoconazole (which directly suppresses steroidogenesis) biochemically controlled CD patients and lowered their blood pressure after 80 days. Glucocorticoids (GC) modulate the renin–angiotensin–aldosterone system (RAAS) among others by increasing hepatic angiotensinogen expression and stimulating mineralocorticoid receptors (MR). This study therefore evaluated plasma RAAS components in CD patients before and after drug therapy. In addition, we studied whether cabergoline/pasireotide have direct relaxant effects in angiotensin II (Ang II)-constricted iliac arteries of spontaneously hypertensive rats, with and without concomitant GR/MR stimulation with dexamethasone or hydrocortisone.ResultsBaseline concentrations of angiotensinogen were elevated, while renin and aldosterone were low and suppressed, respectively, even in patients treated with RAAS-blockers. This pattern did not change after 80 days of treatment, despite blood pressure normalization, nor after 4 years of remission. In the presence of dexamethasone, pasireotide inhibited Ang II-mediated vasoconstriction.ConclusionsThe low plasma renin concentrations, even under RAAS blockade, in CD may be the consequence of increased GC-mediated MR stimulation and/or the elevated angiotensinogen levels in such patients. The lack of change in RAAS-parameters despite blood pressure and cortisol normalization suggests persisting consequences of long-term exposure to cortisol excess. Finally, pasireotide may have a direct vasodilating effect contributing to blood pressure lowering.

scholarly journals Epicardial Adipose Tissue and Renal Disease

2019 ◽  
Vol 8 (3) ◽  
pp. 299 ◽  
Author(s):  
Narothama Aeddula ◽  
Wisit Cheungpasitporn ◽  
Charat Thongprayoon ◽  
Samata Pathireddy
Keyword(s):  
Adipose Tissue ◽  
Cardiovascular Diseases ◽  
Renal Disease ◽  
Epicardial Adipose Tissue ◽  
Renal Diseases ◽  
Cardiovascular Morbidity And Mortality ◽  
Noninvasive Biomarker ◽  
Visceral Layer ◽  
And Function ◽  
Inflammatory Molecules

Epicardial adipose tissue (EAT) is derived from splanchnic mesoderm, localized anatomically between the myocardium and pericardial visceral layer, and surrounds the coronary arteries. Being a metabolically active organ, EAT secretes numerous cytokines, which moderate cardiovascular morphology and function. Through its paracrine and vasocrine secretions, EAT may play a prominent role in modulating cardiac function. EAT protects the heart in normal physiological conditions by secreting a variety of adipokines with anti-atherosclerotic properties, and in contrast, secretes inflammatory molecules in pathologic conditions that may play a dynamic role in the pathogenesis of cardiovascular diseases by promoting atherosclerosis. Considerable research has been focused on comparing the anatomical and biochemical features of EAT in healthy people, and a variety of disease conditions such as cardiovascular diseases and renal diseases. The global cardiovascular morbidity and mortality in renal disease are high, and there is a paucity of concrete evidence and societal guidelines to detect early cardiovascular disease (CVD) in this group of patients. Here we performed a clinical review on the existing evidence and knowledge on EAT in patients with renal disease, to evaluate its application as a reliable, early, noninvasive biomarker and indicator for CVD, and to assess its significance in cardiovascular risk stratification.

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