Role of renal and extrarenal reninangiotensin system in the mechanism of arterial hypertension and its sequelae

Abstract

The role of the renin-angiotensin system in cardiovascular function and disease has long been recognized. The renin-angiotensin system was originally thought to be only active in the plasma as a circulating endocrine system, controlling blood pressure and electrolyte homeostasis. The recent introduction of new biotechnologies to cardiovascular research has demonstrated that the renin-angiotensin system can operate as both an endocrine (circulating) and an autocrine/paracrine (tissue) system. The endocrine component is involved with acute circulating homeostasis, whereas it is believed that the tissue renin-angiotensin system participates in the tonic regulation of cardiovascular function and structure. Multiple lines of evidence support the presence of complete renin-angiotensin systems in the central nervous system, vasculature, adrenal, heart, kidney, and reproductive organs. Although more research is necessary to delineate the role of tissue renin-angiotensin systems in local tissue function, the significant contribution of the renin-angiotensin system in the pathophysiology of cardiovascular disease is increasingly apparent (Table 1). (Steroids 58:566–572, 1993)