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Angiotensin II as a cardiovascular risk factor

Journal of Human Hypertension volume 16, pages S2–S6 (2002)Cite this article

Abstract

A renin-angiotensin level that is inappropriately high for the systemic blood pressure and the state of sodium balance is now recognized to be one of the modifiable cardiovascular risk factors. Angiotensin acts both as a circulating hormone and as a locally acting paracrine/autocrine/intracrine factor. The adverse effects of angiotensin on the heart include the mechanical results of elevated resistance to the pumping function of the myocardium, as well as the effects of neurohumoral abnormalities on various cardiac structures. In addition, cardiac damage follows acute ischaemic injury or chronic energy starvation due to coronary artery disease, attributable to either mechanical obstruction (atherosclerotic and/or thrombotic) or functional stenosis (vasospasm). Activation of the renin-angiotensin system has several haemodynamic and humoral consequences, all of which may damage the myocardium. These include acute myocardial ischaemia, left-ventricular hypertrophy, arrhythmias, alterations in the coagulation–fibrinolysis equilibrium, increased oxi- dative stress, and pro-inflammatory activity. A brief review of some of the mechanisms by which activation of the renin-angiotensin system can inflict damage on the heart is presented.

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  1. Hypertension and Atherosclerosis Section of the Department of Medicine, Boston University School of Medicine, Boston, MA, USA

    I Gavras & H Gavras

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Gavras, I., Gavras, H. Angiotensin II as a cardiovascular risk factor. J Hum Hypertens 16 (Suppl 2), S2–S6 (2002). https://doi.org/10.1038/sj.jhh.1001392

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