The role of angiotensin II receptors and their antagonists in hypertension. 2000

P A van Zwieten
Department of Pharmacotherapy, Academic Medical Center, University of Amsterdam, The Netherlands.

The octapeptide angiotensin II is the major effector of the renin-angiotensin-aldosterone system. Angiotensin II causes a variety of potentially noxious biological effects, such as vasoconstriction, a rise in blood pressure, release of aldosterone, enhancement of the effect of catecholamines, and vascular and myocardial hypertrophy, including remodeling of the heart after myocardial infarction. All of these noxious effects of angiotensin II are mediated by angiotensin II receptors (AT receptors) of the AT1 subtype. The functional effects of AT2 receptors, which have been characterized by means of biochemical techniques, are so far not clearly identified. Stimulation of the AT2 receptor by means of angiotensin II is assumed to counteract vascular/myocardial remodeling and possibly to induce vasodilation. Accordingly, AT1 and AT2 receptors are believed to provoke opposite effects. It has drawn attention that fetal tissues contain a high density of AT2 receptors, which is lowered significantly after birth. The identification and analysis of AT receptors has been greatly stimulated by the development of non-peptidergic AT1 receptor antagonists, of which losartan is the prototype. It is so far unclear whether AT receptors are activated in hypertensive disease. A survey will be made of the hemodynamic effects of AT1 receptor antagonists, their interaction with AT receptors, and the probably important role of the sympathetic nervous system involved in the antihypertensive action of AT receptor antagonists.

UI MeSH Term Description Entries
D006973 Hypertension Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more. Blood Pressure, High,Blood Pressures, High,High Blood Pressure,High Blood Pressures
D011945 Receptors, Angiotensin Cell surface proteins that bind ANGIOTENSINS and trigger intracellular changes influencing the behavior of cells. Angiotensin Receptor,Angiotensin Receptors,Angiotensin II Receptor,Angiotensin III Receptor,Receptor, Angiotensin II,Receptor, Angiotensin III,Receptor, Angiotensin
D012084 Renin-Angiotensin System A BLOOD PRESSURE regulating system of interacting components that include RENIN; ANGIOTENSINOGEN; ANGIOTENSIN CONVERTING ENZYME; ANGIOTENSIN I; ANGIOTENSIN II; and angiotensinase. Renin, an enzyme produced in the kidney, acts on angiotensinogen, an alpha-2 globulin produced by the liver, forming ANGIOTENSIN I. Angiotensin-converting enzyme, contained in the lung, acts on angiotensin I in the plasma converting it to ANGIOTENSIN II, an extremely powerful vasoconstrictor. Angiotensin II causes contraction of the arteriolar and renal VASCULAR SMOOTH MUSCLE, leading to retention of salt and water in the KIDNEY and increased arterial blood pressure. In addition, angiotensin II stimulates the release of ALDOSTERONE from the ADRENAL CORTEX, which in turn also increases salt and water retention in the kidney. Angiotensin-converting enzyme also breaks down BRADYKININ, a powerful vasodilator and component of the KALLIKREIN-KININ SYSTEM. Renin-Angiotensin-Aldosterone System,Renin Angiotensin Aldosterone System,Renin Angiotensin System,System, Renin-Angiotensin,System, Renin-Angiotensin-Aldosterone
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000959 Antihypertensive Agents Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS. Anti-Hypertensive,Anti-Hypertensive Agent,Anti-Hypertensive Drug,Antihypertensive,Antihypertensive Agent,Antihypertensive Drug,Anti-Hypertensive Agents,Anti-Hypertensive Drugs,Anti-Hypertensives,Antihypertensive Drugs,Antihypertensives,Agent, Anti-Hypertensive,Agent, Antihypertensive,Agents, Anti-Hypertensive,Agents, Antihypertensive,Anti Hypertensive,Anti Hypertensive Agent,Anti Hypertensive Agents,Anti Hypertensive Drug,Anti Hypertensive Drugs,Anti Hypertensives,Drug, Anti-Hypertensive,Drug, Antihypertensive,Drugs, Anti-Hypertensive,Drugs, Antihypertensive
D057911 Angiotensin Receptor Antagonists Agents that antagonize ANGIOTENSIN RECEPTORS. Many drugs in this class specifically target the ANGIOTENSIN TYPE 1 RECEPTOR. Angiotensin II Receptor Antagonist,Angiotensin II Receptor Blocker,Angiotensin Receptor Antagonist,Angiotensin Receptor Blocker,Angiotensin II Receptor Antagonists,Angiotensin II Receptor Blockers,Angiotensin Receptor Blockers,Antagonist, Angiotensin Receptor,Antagonists, Angiotensin Receptor,Blocker, Angiotensin Receptor,Receptor Antagonist, Angiotensin,Receptor Antagonists, Angiotensin,Receptor Blocker, Angiotensin,Receptor Blockers, Angiotensin

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