Skip to main content
SpringerLink
Log in

Clinical Import of the Local Renin Angiotensin Aldosterone Systems

  • Chapter
  • First Online:
Renin Angiotensin System and Cardiovascular Disease

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

The concept of local renin angiotensin (and possibly aldosterone) systems has been a relatively recent interjection to the investigative milieu. Much interest and important studies have resulted, and reference to applicability to disease and disease mechanisms is still of innovative and imaginative clinical and experimental studies. To this end, there are several areas of pertinence which have evolved including the underlying causations, mechanisms, and treatment of a number of diseases. Among those fascinating and provocative study areas is the need for additional motivated investigation related to ventricular and vascular hypertrophy, remodeling, and cardiac and renal failure and new thinking related to lifestyle modifications (including those related to salt excess, obesity, and responses to various drugs, clinically useful or otherwise). We have much confidence that these and other areas for study will be productive and useful and will lead to important clinical approaches and contributions on the issue of existing local RAAS.

Much of the present-day clinical and investigative considerations of the renin angiotensin aldosterone system (RAAS) as well as this monograph concern the classically accepted endocrine RAAS system. The overall concepts involved have been extremely important in understanding the biology, physiology, and clinical relevance of this system as it pertains to cardiovascular and renal diseases, and they have led to the synthesis of new classes of therapeutic agents which have changed dramatically approaches to disease. Consequently, these changes have resulted in remarkable reductions in the morbidity and mortality of cardiovascular, renal, brain, and other diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Fyhrquist, F., and Saijonmaa, O. (2008) Renin-angiotensin system revisited. Intern Med 264, 224–236.

    Article  CAS  Google Scholar 

  2. Harrison, D.G., and Cai, H. (2003) Endothelial control of vasomotion and nitric oxide production. Cardio Clin 21, 289–302.

    Article  Google Scholar 

  3. Besler, C., Doerries,C., Giannotti,G., Luscher,T.F., and Landmesse, U. (2008) Pharmacological approaches to improve endothelial repair mechanisms. Expert Rev Cardiovasc Ther 6, 1071–1082.

    Google Scholar 

  4. Varagic, J., Trask, A.J., Jessup, J.A., Chappell, M.C., and Ferrario, C.M. (2008) New angiotensins. J Mol Med 86, 663–671.

    Article  CAS  PubMed  Google Scholar 

  5. Paul, M., Mehr, A.P., and Kreutz R (2006) Physiology of local renin angiotensin systems. Physiol Rev 86, 747–803.

    Article  CAS  PubMed  Google Scholar 

  6. Pfeffer, M.A., and Frohlich, E.D. (2006) Improvements in clinical outcomes with the use of angiotensin converting enzyme inhibitors: cross-fertilization between clinical and basic investigation. Am J Physiol Heart Circ 291, H2021–H2025.

    Article  CAS  Google Scholar 

  7. Frohlich, E.D., and Re, R.N. (eds) (2006) The Local Cardiac Renin Angiotensin-Aldosterone System. Springer, New York.

    Google Scholar 

  8. Kannel, W.B., Dawber, T.R., Kagan, A., Revorskie, N., and Sacks, J. (1961) Factors of risk in the development of coronary heart disease: six year follow up experience: the Framingham Study. Ann Intern Med 55, 33–56.

    CAS  PubMed  Google Scholar 

  9. Frohlich, E.D., Tarazi, R.C., and Dustan, H.P. (1971) Clinical-physiological correlations in the development of hypertensive heart disease. Circulation 44, 446–455.

    CAS  PubMed  Google Scholar 

  10. Dunn, F.G., Chandraratna, P., de Carvalho, J.G.R., Basta, L.L., and Frohlich. E.D. (1977) Pathophysiologic assessment of hypertensive heart disease with echocardiography. Am J Cardiol 39, 789–795.

    Article  CAS  PubMed  Google Scholar 

  11. Frohlich, E.D., and Tarazi, R.C. (1979) Is arterial pressure the sole factor responsible for hypertensive cardiac hypertrophy? Am J Cardiol 44, 959–963.

    Article  CAS  PubMed  Google Scholar 

  12. Frohlich, E.D. (1983) Hemodynamics and other determinants in development of left ventricular hypertrophy: conflicting factors in its regression. Fed Proceed 42, 2709–2715.

    CAS  Google Scholar 

  13. Tarazi, R.C., and Frohlich, E.D. (1987) Is reversal of cardiac hypertrophy a desirable goal of antihypertensive therapy? Circulation 75, 113–117.

    Google Scholar 

  14. Frohlich, E.D. (1988) State of the Art. The heart in hypertension: unresolved conceptual challenges. Hypertension 11, 19–24.

    Google Scholar 

  15. Sasaki, O., Kardon, M.B., Pegram, B.L., and Frohlich, E.D. (1989) Aortic distensibility and left ventricular pumping ability after methyldopa in Wistar-Kyoto and spontaneously hypertensive rats. J Vascular Med Biol 1, 59–66.

    Google Scholar 

  16. Natsume, T., Kardon, M.B., Pegram, B.L., and Frohlich, E.D. (1989) Ventricular performance in spontaneously hypertensive rats with reduced cardiac mass. Cardiovasc Drug Ther 3, 433–439.

    Article  CAS  Google Scholar 

  17. Frohlich, E.D. (1989) Overview of hemodynamic and non-hemodynamic factors associated with LVH. J Mol Cell Cardio 21(Suppl V), 3–10.

    Article  Google Scholar 

  18. Frohlich, E.D., and Sasaki, O. (1990) Dissociation of changes in cardiovascular mass and performance with angiotensin converting enzyme inhibitors in Wistar-Kyoto and spontaneously hypertensive rats. J Am Coll Cardiol 16, 1492–1499.

    Article  CAS  PubMed  Google Scholar 

  19. Frohlich, E.D., and Horinaka, S.(1991) Cardiac and aortic effects of angiotensin converting enzyme inhibitors. Hypertension 18, 2–7.

    Google Scholar 

  20. Ando, K., Frohlich, E.D., Chien, Y., and Pegram, B.L. (1991) Effects of quinapril on systemic and regional hemodynamics and cardiac mass in spontaneously hypertensive and Wistar-Kyoto rats. J Vascular Med Biol 3, 117–123.

    Google Scholar 

  21. Frohlich, E.D., Sasaki, O., Chien, Y., and Arita, M. (1992) Changes in cardiovascular mass, left ventricular pumping ability, and aortic distensibility after calcium antagonist in Wistar-Kyoto and spontaneously hypertensive rats. J Hypertens 10, 1369–1378.

    Article  CAS  PubMed  Google Scholar 

  22. Soria, F., Frohlich, E.D., Aristizabal, D., Kaneko, K., Kardon, M.B., Hunter, J., and Pegram, B.L. (1994) Preserved cardiac performance with reduced left ventricular mass in conscious exercising spontaneously hypertensive rats. J Hypertens 12, 585–589.

    Article  CAS  PubMed  Google Scholar 

  23. Frohlich, E.D (1994) Okamoto International Award Lecture: The spontaneously hypertensive rat. Jpn Heart J 35, 487–491.

    Google Scholar 

  24. Susic, D., Nunez, E., Hosoya, H., and Frohlich, E.D. (1998) Coronary hemodynamics in aging spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) rats. J Hypertens 16, 231–237

    Google Scholar 

  25. Frohlich, E.D. (1999) Risk mechanisms in hypertensive heart disease. Hypertension 34, 782–789.

    CAS  PubMed  Google Scholar 

  26. Frohlich, E.D. (2001) Fibrosis and Ischemia: The real risks in hypertensive heart disease. Am J Hypertension 14, 194S–199S.

    Article  CAS  Google Scholar 

  27. Fortuño, M.A., González, A., Ravassa, S., López, B., and Díez, J. (2003) Clinical implications of apoptosis in hypertensive heart disease. Am J Physiol Heart Circ Physio 284, H1495–H1506.

    Google Scholar 

  28. Ahn, J., Varagic, J., Slama, M., Susic, D., and Frohlich, E.D. (2004) Cardiac structural and functional responses to salt loading in SHR. Am J Physiol (Heart Circ Physiol) 287, H767–H772.

    Article  CAS  Google Scholar 

  29. Varagic, J., Frohlich, E.D., Diez, J., Susic, D., Ahn, J., Gonzalez, A., and Lopez, B. (2006) Myocardial fibrosis, impaired coronary hemodynamics, and biventricular dysfunction in salt-loaded SHR. Am J Physiol (Heart Circ Physiol) 290, H1503–H1509.

    Article  CAS  Google Scholar 

  30. Matavelli, L.C., Zhou, X., Varagic, J., Susic, D., and Frohlich, E.D. (2007) Salt-loading produces severe renal hemodynamic dysfunction independent of arterial pressure in spontaneously hypertensive rats. Am J Physiol (Heart Circ Physiol) 292,H814–H819.

    Article  CAS  Google Scholar 

  31. Pfeffer, M.A. (2009) Inhibiting the renin angiotensin aldosterone system in patients with heart failure and myocardial infarction. In: DeMello, W.C., Frohlich, E.D., (eds.) Renin Angiotensin Aldosterone System and Cardiovascular Disease. Humana Press, Totowa, NJ, Chapter 8 of this book.

  32. Diez, J., and Frohlich, E.D. (2009) Left ventricular hypertrophy and treatment with renin angiotensin system inhibition. In: DeMello, W.C., Frohlich, E.D., (eds.) Renin Angiotensin Aldosterone System and Cardiovascular Disease. Humana Press, Totowa, NJ, Chapter 9 of this book.

  33. Frohlich, E.D. (2007) The salt conundrum: a hypothesis. Hypertension 50, 161–166.

    Article  CAS  PubMed  Google Scholar 

  34. Frohlich, E.D. (2008) The role of salt in hypertension: the complexity seems to become clearer. Nat Clin Pract Cardiovasc Med 5, 2–3.

    Article  CAS  PubMed  Google Scholar 

  35. Varagic, J., Frohlich, E.D., Susic, D., Ahn, J., Matavelli, L., Lopez, B., and Diez, J. (2008) AT1 receptor antagonism attenuates target organ effects of salt excess in SHRs without affecting pressure. Am J Physiol Heart Circ 294, H853–H353.

    Google Scholar 

  36. Cook, N.R., Cutler, J.A., Obarzanek, E., Buring, J.E., Rexrode, K.M., Kumanyika, S, K., Appel, L.J., and Whelton, P. K. (2007) Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP), BMJ 334, 885–894.

    Google Scholar 

  37. Kurlansky, M. (2003) Salt: A World History. Penguin Books, New York

    Google Scholar 

  38. Dahl, L.K., and Love, R.A. (1954) Evidence for a relationship between sodium (chloride) intake and human essential hypertension. Arch Intern Med 94, 525–531.

    CAS  Google Scholar 

  39. Stamler, J. (1997) The INTERSALT study: background, methods, findings, and implications. Am J Clin Natr 65, 626–642.

    Google Scholar 

  40. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) (2003). JAMA, 289, 2560–2572.

    Google Scholar 

  41. International Society of Hypertension Writing Group. International Society of Hypertension (ISH): Statement on blood pressure lowering and stroke prevention (2003). J Hypertens 21, 651–663.

    Article  Google Scholar 

  42. Ono, Y., Ono, H., and Frohlich, E.D. (1996) Hydrochlorothiazide exacerbates nitric oxide-blockade nephrosclerosis with glomerular hypertension in spontaneously hypertensive rats. J Hypertens 14, 823–828.

    Article  CAS  PubMed  Google Scholar 

  43. Zhou, X., Matavelli, L.C., Ono, H., and Frohlich, E.D. (2005) Superiority of combination of thiazide with angiotensin-converting enzyme inhibitor or AT1 – receptor blocker over thiazide alone on renoprotection in L-NAME/SHR. Am J Physiol Renal 289, F871–F879.

    Article  CAS  Google Scholar 

  44. Schunkert, H., Ingelfinger, J.R., Jacob, H., Jackson, B., Bouyounes, B., and Dzau, V.J. (1992) Reciprocal feedback regulation of kidney angiotensinogen and renin RNA expressions by angiotensin II. Am J Physiol E863–E869.

    Google Scholar 

  45. Navar, L.G., Prieto-Carrasquero, M.C., and Kobori, H. (2005) Regulation of renin in JGA and tubules in hypertension. In: Frohlich, E.D., Re, R.N., (eds.) The Local Cardiac Renin Angiotensin-Aldosterone System. Springer Science –Business Media, Inc, New York, 22–29.

    Google Scholar 

  46. Herse, F., Dechend, R., Harsem, N.K., Wallukat, G., Jurgen, J., Fatimunnisa, Q., Hering, L., Muller, D.N., Lucct, F.C., and Staff, A.C. (2007) Dysregulation of the circulating and tissue-based renin-angiotensin system in preeclampsia. Hypertension 49(2), 604–611.

    Article  CAS  PubMed  Google Scholar 

  47. LaMarca, B.D., Gilbert, J., and Granger, J.P. (2008) Recent progress toward the understanding of the pathophysiolsogy of hypertensions during preeclampsia. Hypertension 51, 982–988.

    Article  CAS  PubMed  Google Scholar 

  48. Robert, J.M., Pearson, G., Cutler, J., and Lindheimer, M. (2003) Summary of the NHLBI working group on research on hypertension during pregnancy. Hypertension 41, 437–445.

    Google Scholar 

  49. Robert, J.M., and Von Versen-Hoeynck, F. (2007) Maternal fetal/placental interactions and abnormal pregnancy outcomes. Hypertension 49, 15–16.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ochsner Clinic Foundation, New Orleans, LA, USA

    Edward D. Frohlich

Authors
  1. Edward D. Frohlich
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Edward D. Frohlich .

Editor information

Editors and Affiliations

  1. Department of Pharmacology, University of Puerto Rico, San Juan, 00936, U.S.A.

    Walmor C. DeMello

  2. Ochsner Clinic Foundation, Jefferson Highway 1514 , New Orleans, 70121, U.S.A.

    Edward D. Frohlich

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Frohlich, E.D. (2009). Clinical Import of the Local Renin Angiotensin Aldosterone Systems. In: DeMello, W., Frohlich, E. (eds) Renin Angiotensin System and Cardiovascular Disease. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-60761-186-8_2

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-186-8_2

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60761-185-1

  • Online ISBN: 978-1-60761-186-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation