Hypertension: renin-angiotensin-aldosterone system alterations

Circulation Research
Luuk Te RietA H Jan Danser

Abstract

Blockers of the renin-angiotensin-aldosterone system (RAAS), that is, renin inhibitors, angiotensin (Ang)-converting enzyme (ACE) inhibitors, Ang II type 1 receptor antagonists, and mineralocorticoid receptor antagonists, are a cornerstone in the treatment of hypertension. How exactly they exert their effect, in particular in patients with low circulating RAAS activity, also taking into consideration the so-called Ang II/aldosterone escape that often occurs after initial blockade, is still incompletely understood. Multiple studies have tried to find parameters that predict the response to RAAS blockade, allowing a personalized treatment approach. Consequently, the question should now be answered on what basis (eg, sex, ethnicity, age, salt intake, baseline renin, ACE or aldosterone, and genetic variance) a RAAS blocker can be chosen to treat an individual patient. Are all blockers equal? Does optimal blockade imply maximum RAAS blockade, for example, by combining ≥2 RAAS blockers or by simply increasing the dose of 1 blocker? Exciting recent investigations reveal a range of unanticipated extrarenal effects of aldosterone, as well as a detailed insight in the genetic causes of primary aldosteronism, and mineralocorticoid recepto...Continue Reading

Associated Clinical Trials

References

Jul 1, 1994·Hypertension·A H DanserM A Schalekamp
Mar 16, 1996·Lancet·Y T van der SchouwJ D Banga
Jan 1, 1997·American Journal of Hypertension·M H AldermanJ H Laragh
Aug 1, 1997·Journal of Human Hypertension·J A StaessenR Fagard
May 1, 1999·Biochemical and Biophysical Research Communications·M TanakaT Inagami
Oct 8, 1999·The Journal of Clinical Investigation·Y TsutsumiT Iwasaka
Dec 12, 2001·Kidney International·J P van KatsA H Danser
Nov 16, 2002·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·John W WrightJoseph W Harding
Jun 28, 2003·Proceedings of the National Academy of Sciences of the United States of America·Robson A S SantosThomas Walther
Aug 20, 2003·Hypertension·Stephen B HarrapUNKNOWN PROGRESS Collaborative Group
Jan 7, 2004·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Julia M Orshal, Raouf A Khalil
Apr 13, 2004·Journal of Hypertension·Agostino VirdisErnesto L Schiffrin
May 12, 2004·Proceedings of the National Academy of Sciences of the United States of America·Marie-Claude Fournie-ZaluskiCatherine Llorens-Cortes
Jul 2, 2004·The New England Journal of Medicine·Ramachandran S VasanDaniel Levy
Jul 31, 2004·Acta Physiologica Scandinavica·V GrossF C Luft
Aug 17, 2004·Endocrinology·Elise P Gomez-SanchezCelso E Gomez-Sanchez
Jan 1, 2005·American Journal of Physiology. Heart and Circulatory Physiology·Baojian XueMeredith Hay
Jun 9, 2005·The Journal of Clinical Endocrinology and Metabolism·Michael StowasserThomas H Marwick
Jun 28, 2005·The European Journal of Neuroscience·J XuA P Arnold
Apr 4, 2006·American Journal of Hypertension·Michelangelo SartoriAndrea Semplicini
May 10, 2006·British Journal of Pharmacology·Joep H M van EschA H Jan Danser
Aug 1, 2006·The Journal of Clinical Investigation·Susan B GurleyThomas M Coffman
Mar 3, 2007·The Journal of Clinical Investigation·Wenzheng ZhangBruce C Kone
Jun 26, 2007·International Journal of Clinical Practice·J NussbergerM F Prescott
Sep 25, 2007·Pflügers Archiv : European journal of physiology·Kristina Kusche-VihrogHans Oberleithner
Sep 27, 2007·European Heart Journal·Nisha I ParikhRamachandran S Vasan
Oct 4, 2007·Proceedings of the National Academy of Sciences of the United States of America·Hans OberleithnerMartin Hausberg
Feb 15, 2008·Annual Review of Physiology·Eric R ProssnitzHelen J Hathaway
Apr 18, 2008·European Journal of Pharmacology·Dilek IusufAnton J M Roks
May 24, 2008·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Florian GembardtThomas Walther
May 29, 2008·The Journal of Clinical Endocrinology and Metabolism·David S GellerRichard P Lifton

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Citations

Jan 19, 2016·Journal of the American Society of Hypertension : JASH·Roy O MathewArif Asif
Mar 19, 2016·Cellular and Molecular Neurobiology·T Michael De Silva, Frank M Faraci
Apr 22, 2016·The Journal of Clinical Hypertension·Martin R GrüblerStefan Pilz
Jun 21, 2016·Journal of the American Society of Hypertension : JASH·Joana Delgado SilvaLino Gonçalves
Aug 11, 2016·Metabolism: Clinical and Experimental·Pingping YangGaosi Xu
Apr 14, 2016·Pharmacotherapy·Joel C Marrs, Angela M Thompson
Aug 5, 2016·Pharmacology & Therapeutics·Laura Prieto-GarcíaFrancisco J López-Hernández
Sep 7, 2016·BMC Cardiovascular Disorders·Isabel GonçalvesUNKNOWN SUMMIT consortium
Jul 20, 2016·American Journal of Hypertension·Monica T J SchüttenPeter W de Leeuw
Nov 2, 2016·BioMed Research International·Bae Huey TeeSau Kuen Lam
Nov 12, 2016·Current Hypertension Reports·Miruna NemeczAdriana Georgescu
Feb 18, 2017·International Journal of Molecular Sciences·You-Lin Tain, Chien-Ning Hsu
May 13, 2017·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Sandosh PadmanabhanAnna F Dominiczak
Apr 7, 2017·Canadian Journal of Physiology and Pharmacology·Domenico Regoli, Fernand Gobeil
May 24, 2017·Clinical and Experimental Hypertension : CHE·Hong XieLiangdi Xie
Jun 3, 2017·Pharmacological Research : the Official Journal of the Italian Pharmacological Society·Carlos M Ferrario, Adam E Mullick
Mar 10, 2018·The Journal of Clinical Hypertension·Yandiswa Y YakoAndre P Kengne
Oct 7, 2017·American Journal of Hypertension·Jürgen M BohlenderHans Imboden
Dec 1, 2017·Clinical and Experimental Hypertension : CHE·Misbah Hussain, Fazli Rabbi Awan
Feb 24, 2018·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Irma Isordia-SalasAbraham Majluf-Cruz
Oct 27, 2017·Cell Death & Disease·Dan ChenGuo-Qing Zhu
Oct 4, 2017·Toxicological Sciences : an Official Journal of the Society of Toxicology·Xiuduan XuLun Song
Jun 7, 2018·Physiological Reviews·Steven J ForresterSatoru Eguchi
Apr 24, 2018·British Journal of Pharmacology·Barbara SchreierAlexander Zipprich
Apr 25, 2018·The Journal of Clinical Investigation·Amber EmmersonAjay M Shah
Feb 25, 2018·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Mario Fritsch NevesWille Oigman
Jun 10, 2015·Hypertension·Kate M Denton
Jun 23, 2016·Journal of the American Heart Association·Pauliina KangasIlkka Pörsti

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