• ARBs
  • 10 ) report the results of a retrospective longitudinal cohort study of patients with echocardiographic diagnoses of moderate or severe AR, comparing those who did versus those who did not receive ACE inhibitors or ARBs. (onlinejacc.org)
  • cardiac
  • The invention relates to a method of treating cardiac insufficiency by using compounds of the formula I ##STR1## in which n is 1 or 2, R, R 1 , R 2 and R 3 are identical or different and each denote hydrogen or an organic radical and R 4 R 5 , together with the atoms carrying them, form a mono-, bi- or tri-cyclic heterocyclic ring system. (google.com)
  • These findings are based on De Mello's studies 1 of renin, angiotensin I, and angiotensin II dialyzed into rat cardiac cells. (ahajournals.org)
  • The evidence for the influence of an intracellular AT 1 -like angiotensin II receptor on intercellular communication is compelling and supports the concept of an intracrine angiotensin II system in the heart, with possible implications for cardiac conduction and contractility in health and disease. (ahajournals.org)
  • 6 Thus, evidence is emerging to indicate that angiotensin II can perform a variety of physiologically relevant intracrine actions, including influencing cardiac conduction and contractility. (ahajournals.org)
  • Contribution of cardiac renin-angiotensin system to ventricular remodelling in myocardial-infarcted rats. (wikipedia.org)
  • Its principal effector is the octapeptide angiotensin II (ANG II), a pluripotential hormone whose biological actions, including blood pressure regulation, fluid osmolarity and cardiac function, have been extensively studied in mammalian and non-mammalian vertebrates (for references, see Kobayashi and Takei, 1996 ). (biologists.org)
  • An emerging hypothesis suggests that the activity of the angiotensin II type 2 receptor (AT 2 ) may counterregulate AT 1 receptor effects during cardiac development and during the evolution of cardiac hypertrophy and heart failure. (ahajournals.org)
  • Later, they were found useful for other cardiovascular and kidney diseases including: Acute myocardial infarction (heart attack) Cardiac failure (left ventricular systolic dysfunction) Kidney complications of diabetes mellitus (diabetic nephropathy) In treating heart disease, ACE inhibitors are usually used with other medications. (wikipedia.org)
  • When the cells are stimulated, pro-ANP is released and converted to the 28-amino-acid C-terminal mature ANP on the cell surface by the cardiac transmembrane serine protease corin. (wikipedia.org)
  • synthesis
  • 2 In this regard, it can be noted that once the possibility of intracellular angiotensin action is accepted, quantitative arguments discounting the importance of local synthesis of renin or angiotensinogen become less compelling, in that effective intracellular concentrations of hormone can be achieved even if only small quantities of protein are produced. (ahajournals.org)
  • Altogether, this research paves the way for a better understanding of the intracellular mechanisms involved in the synthesis of angiotensin peptides and its consequences in terms of cell function in both physiology and pathology. (springer.com)
  • kidney
  • This characteristic of fosinopril makes the drug a safer choice than other ACE inhibitors for heart failure patients with impaired kidney function resulting from poor perfusion as fosinopril can still be eliminated by the liver, preventing accumulation of the drug in the body. (wikipedia.org)
  • Chappell MC, Allred AJ, Ferrario CM. Pathways of angiotensin-(1-7) metabolism in the kidney. (springer.com)
  • As such, ACE inhibitors should be the drug treatment of choice for patients with chronic kidney disease regardless of race or diabetic status. (wikipedia.org)
  • ACE inhibitors have also been used in chronic kidney failure and kidney involvement in systemic sclerosis (hardening of tissues, as scleroderma renal crisis). (wikipedia.org)
  • Markers of electrolyte and water imbalance in the body such as hypotension, low distal tubule sodium concentration, decreased blood volume and high sympathetic tone trigger the release of the enzyme renin from the cells of juxtaglomerular apparatus in the kidney. (wikipedia.org)
  • Diagnostic pointers include high urinary potassium and chloride despite low serum values, increased plasma renin, hyperplasia of the juxtaglomerular apparatus on kidney biopsy, and careful exclusion of diuretic abuse. (wikipedia.org)
  • Myocardial
  • In the 1970s, scientists first observed Ang II to harm the heart and kidneys, and individuals with high levels of renin activity in plasma were at increased risk of myocardial infarction and stroke. (wikipedia.org)
  • sodium
  • Since neurohormonal systems are often stimulated in the heart failure syndrome, activation of the sympathetic nervous system and the renin angiotensin system is often implicated in sodium retention, edema formation and some other symptoms of heart failure. (aafp.org)
  • Also possibly related is the observation that some effects of angiotensin on sodium transport by renal tubular cells appear to require hormone internalization. (ahajournals.org)
  • Pharmacokinetics, Safety, and Pharmacologic Effects of Fosinopril Sodium, an Angiotensin-Converting Enzyme Inhibitor in Healthy Subjects. (wikipedia.org)
  • It can also be activated by a decrease in the filtrate sodium chloride (NaCl) concentration or a decreased filtrate flow rate that will stimulate the macula densa to signal the juxtaglomerular cells to release renin. (wikipedia.org)
  • Loss of function of this reabsorption system results in decreased sodium, potassium, and chloride reabsorption in the thick ascending limb, as well as abolishment of the lumen-positive voltage, resulting in decreased calcium and magnesium reabsorption. (wikipedia.org)
  • Loss of reabsorption of sodium here also has the undesired effect of abolishing the hypertonicity of the renal medulla, severely impairing the ability to reabsorb water later in the distal nephron and collecting duct system, leading to significant diuresis and the potential for volume depletion. (wikipedia.org)
  • ACEIs
  • Some studies further pointed out that ACE1 inhibitors (ACEIs) have become first-line drugs for some fertile issues [ 18 , 19 ]. (mdpi.com)
  • Understanding the basis and context of EBM will help veterinarians understand why certain publications are given more weight than others in the development of recommendations, which is particularly true in the case of angiotensin-converting enzyme (ACE) inhibitors (ACEIs). (scielo.org.za)
  • selective
  • The highly selective aspartic protease renin is secreted from the juxtaglomerular apparatus, which is the only source of active renin, although its precursor, prorenin, can be secreted by other tissues, such as the salivary glands, brain, heart and blood vessels. (wikipedia.org)
  • kidneys
  • When renal blood flow is reduced, juxtaglomerular cells in the kidneys convert the precursor - prorenin, already present in the blood into renin and secrete it directly into the circulation. (wikipedia.org)
  • In the kidneys, angiotensin II constricts glomerular arterioles, having a greater effect on efferent arterioles than afferent. (wikipedia.org)
  • In 1896, the Finnish physiologist Robert Tigerstedt and the Swedish physician Per Bergman did an experiment on kidneys and the circulatory system in rabbits. (wikipedia.org)
  • Their results suggested the kidneys produced a protein, which they named renin, that caused a rise in blood pressure. (wikipedia.org)
  • extracellular
  • Most serpins are protease inhibitors, targeting extracellular, chymotrypsin-like serine proteases. (wikipedia.org)
  • For example, extracellular serpins regulate the proteolytic cascades central to blood clotting (antithrombin), the inflammatory and immune responses (antitrypsin, antichymotrypsin, and C1-inhibitor) and tissue remodelling (PAI-1). (wikipedia.org)
  • outcomes
  • This led to the hypothesis that the I/D polymorphism may influence the effect of ACE inhibitors on clinical outcomes. (biomedcentral.com)
  • A retrospective analysis of five million patient records with the US Department of Veterans Affairs system found different types of commonly used antihypertensive medications had very different AD outcomes. (wikipedia.org)
  • Mechanism
  • It was the first ACE inhibitor developed and was considered a breakthrough both because of its novel mechanism of action and also because of the revolutionary development process. (wikipedia.org)
  • This contrasts with the more common competitive mechanism for protease inhibitors that bind to and block access to the protease active site. (wikipedia.org)
  • Serpins act as irreversible, suicide inhibitors by trapping an intermediate of the protease's catalytic mechanism. (wikipedia.org)
  • Circulation
  • Over the last 2 decades, it has become clear that angiotensin can be generated not only in the systemic circulation but also in multiple tissue sites, where its production can be regulated by local factors. (ahajournals.org)
  • Brosnihan KB, Li P, Tallant EA, Ferrario CM. Angiotensin-(1-7): a novel vasodilator of the coronary circulation. (springer.com)
  • blood
  • 1 - 3 In many people with evidence of diabetic renal disease, however, angiotensin converting enzyme (ACE) inhibitors alone fail to achieve blood pressure targets. (bmj.com)
  • However, the direct effects of angiotensin II on islet function and underlying mechanisms independent of changes in blood pressure remain unclear. (diabetesjournals.org)
  • In diabetic animal models, angiotensin II leads to decreased blood flow in insulin target tissues and pancreatic islets, which results in reduced insulin and glucose delivery ( 19 - 21 ). (diabetesjournals.org)
  • Knowledge of the mechanisms by which the rennin-angiotensin system contributes to cardiovascular pathology continues to advance at a rapid pace as newer methods and therapies uncover the nature of this complex system and its fundamental role in the regulation of blood pressure and tissue function. (springer.com)
  • We observed a trend towards better response to ACE inhibitors in Caucasian DD carriers compared to II carriers, in terms of blood pressure, proteinuria, glomerular filtration rate, ACE activity and progression to end-stage renal failure. (biomedcentral.com)
  • The inhibition of this system causes an overall decrease in blood pressure. (wikipedia.org)
  • There are many drugs that interrupt different steps in this system to lower blood pressure. (wikipedia.org)
  • Further information: Autoregulation The system can be activated when there is a loss of blood volume or a drop in blood pressure (such as in hemorrhage or dehydration). (wikipedia.org)
  • To do this, angiotensin II constricts efferent arterioles, which forces blood to build up in the glomerulus, increasing glomerular pressure. (wikipedia.org)
  • Angiotensin II decreases medullary blood flow through the vasa recta. (wikipedia.org)
  • Furthermore, ACE inhibitors were less effective in reducing blood pressure and had a 51% higher risk of stroke in black hypertensives when used as initial therapy compared to a calcium channel blocker. (wikipedia.org)
  • They also discovered this substance responsible for higher blood pressure was produced in the renal cortex, and they named it renin. (wikipedia.org)
  • Renin increases in concentration in the blood as a result of negative feedback of conversion of AI to AII. (wikipedia.org)
  • In 1939, renin was found not to cause the rise in blood pressure, but was an enzyme which catalyzed the formation of the substances that were responsible, namely, angiotensin I (Ang I) and Ang II. (wikipedia.org)
  • proteolytic
  • Although most serpins control proteolytic cascades, some proteins with a serpin structure are not enzyme inhibitors, but instead perform diverse functions such as storage (as in egg white-ovalbumin), transport as in hormone carriage proteins (thyroxine-binding globulin, cortisol-binding globulin) and molecular chaperoning (HSP47). (wikipedia.org)