New drugs for hypertension: What do they offer?

Gradman, Alan H.; Vivas, Yoel

doi:10.1007/s11906-006-0090-z

Cited by 10 publications

(11 citation statements)

References 37 publications

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“…The primary function of renin is to eventually cause an increase in blood pressure, leading to restoration of perfusion pressure in the kidneys. Renin inhibition is indeed associated with lowering of Ang II levels and blood pressure reduction [28] . Ang II, the most active substance of RAAS, has a strong role in vascular remodeling involving vasoconstriction and promotion of development of atherosclerosis, endothelial dysfunction, hypertension and related diseases such as metabolic syndrome, through a variety of inflammation and coagulation mechanism [29,30] .…”

Section: Resultsmentioning

confidence: 99%

Effects of Cyathula officinalis Kuan Extracts on Hypertension-induced Renal Vascular Remodeling by Inhibiting the Expression of ALD, Renin, Ang II and the Activation of Erk1/2 and P38 Signaling Pathways: A Mechanistic Study

Jiajing¹,

Bi²,

Y³

et al. 2020

pharmaceutical-sciences

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Jiajing et al.: Effects of Cyathula officinalis Kuan Extracts on Hypertension-induced Renal Vascular Remodelling The aim of this study was to investigate the role of the extracts of Cyathula officinalis Kuan on blood pressure in spontaneously hypertensive rats and the possible mechanisms involved. Blood pressure was recorded, renal vascular remodelling was visualized through haematoxylin and eosin staining and the expression of aldosterone, renin and angiotensin II in serum and kidney of spontaneously hypertensive rats was measured by real-time polymer chain reaction and enzyme-linked immuno-sorbent assay, respectively. The extracts of Cyathula officinalis Kuan significantly decreased the high blood pressure and reduced renal artery narrowing in spontaneously hypertensive rats. Moreover, Cyathula officinalis Kuan extracts also decreased the expression of aldosterone, renin and angiotensin II in both the serum and the kidney and activated ERK1/2 and p38 signalling pathways in kidney of spontaneously hypertensive rats. However, the toxicity to rat liver and kidney did not differ significantly between the extracts of Cyathula officinalis Kuan and enalapril, a well-known prodrug providing antihypertensive actions. These results demonstrated that the extracts from Cyathula officinalis Kuan can ameliorate hypertension-induced renal vascular remodelling in a rat models through inhibiting the expression of aldosterone, renin and angiotensin II and activating ERK1/2 and p38 signalling pathways.

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Section: Resultsmentioning

confidence: 99%

Effects of Cyathula officinalis Kuan Extracts on Hypertension-induced Renal Vascular Remodeling by Inhibiting the Expression of ALD, Renin, Ang II and the Activation of Erk1/2 and P38 Signaling Pathways: A Mechanistic Study

Jiajing¹,

Bi²,

Y³

et al. 2020

pharmaceutical-sciences

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“…Renin inhibition is indeed associated with the attenuation of Ang I and Ang II levels 39 and BP reduction. 40 Aliskiren reduced BP comparably to β-blockers1, 41 diuretics, 42 ACE–Inhibitors, 43,44 and AT 1 R blockers. 40,45 The possible benefit in renin inhibition might reside in the attenuation of plasma renin activity which is increased by ACE inhibition or AT 1 R blockade.…”

Section: The Renin–angiotensin–aldosterone Systemmentioning

confidence: 98%

“…40 Aliskiren reduced BP comparably to β-blockers1, 41 diuretics, 42 ACE–Inhibitors, 43,44 and AT 1 R blockers. 40,45 The possible benefit in renin inhibition might reside in the attenuation of plasma renin activity which is increased by ACE inhibition or AT 1 R blockade. 46 On the other hand, the high renin levels after aliskiren treatment 47 might escape from renin inhibition and aliskiren may not prevent binding of renin to the (P)RR.…”

Section: The Renin–angiotensin–aldosterone Systemmentioning

confidence: 98%

Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches

Unger

Paulis

Sica

2011

European Heart Journal

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The conventional antihypertensive therapies including renin–angiotensin–aldosterone system antagonists (converting enzyme inhibitors, receptor blockers, renin inhibitors, and mineralocorticoid receptor blockers), diuretics, β-blockers, and calcium channel blockers are variably successful in achieving the challenging target blood pressure values in hypertensive patients. Difficult to treat hypertension is still a commonly observed problem world-wide. A number of drugs are considered to be used as novel therapies for hypertension. Renalase supplementation, vasopeptidase inhibitors, endothelin antagonists, and especially aldosterone antagonists (aldosterone synthase inhibitors and novel selective mineralocorticoid receptor blockers) are considered an option in resistant hypertension. In addition, the aldosterone antagonists as well as (pro)renin receptor blockers or AT2 receptor agonists might attenuate end-organ damage. This array of medications has now been complemented by a number of new approaches of non-pharmacological strategies including vaccination, genomic interference, controlled breathing, baroreflex activation, and probably most successfully renal denervation techniques. However, the progress on innovative therapies seems to be slow and the problem of resistant hypertension and proper blood pressure control appears to be still persisting. Therefore the regimens of currently available drugs are being fine-tuned, resulting in the establishment of several novel fixed-dose combinations including triple combinations with the aim to facilitate proper blood pressure control. It remains an exciting question which approach will confer the best blood pressure control and risk reduction in this tricky disease.

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“…Studies with DRI revealed that renin aggravates HF indirectly though generation of Ang I and activation of Ang I–Ang II–ATI axis or directly via renin receptors. The DRI, aliskiren has a dose-related effect on blood pressure modulation in patients [224,225]. It has been proven safe in normotensive patients from 40–640 mg with daily oral administration [226].…”

Section: Renin Activity As a Bio-target For Pharmacological Intervmentioning

confidence: 99%

Renin Activity in Heart Failure with Reduced Systolic Function—New Insights

Sullivan

Mehta

Tripathi

et al. 2019

IJMS

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Regardless of the cause, symptomatic heart failure (HF) with reduced ejection fraction (rEF) is characterized by pathological activation of the renin–angiotensin–aldosterone system (RAAS) with sodium retention and extracellular fluid expansion (edema). Here, we review the role of active renin, a crucial, upstream enzymatic regulator of the RAAS, as a prognostic and diagnostic plasma biomarker of heart failure with reduced ejection fraction (HFrEF) progression; we also discuss its potential as a pharmacological bio-target in HF therapy. Clinical and experimental studies indicate that plasma renin activity is elevated with symptomatic HFrEF with edema in patients, as well as in companion animals and experimental models of HF. Plasma renin activity levels are also reported to be elevated in patients and animals with rEF before the development of symptomatic HF. Modulation of renin activity in experimental HF significantly reduces edema formation and the progression of systolic dysfunction and improves survival. Thus, specific assessment and targeting of elevated renin activity may enhance diagnostic and therapeutic precision to improve outcomes in appropriate patients with HFrEF.

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New drugs for hypertension: What do they offer?

Cited by 10 publications

References 37 publications

Effects of Cyathula officinalis Kuan Extracts on Hypertension-induced Renal Vascular Remodeling by Inhibiting the Expression of ALD, Renin, Ang II and the Activation of Erk1/2 and P38 Signaling Pathways: A Mechanistic Study

Effects of Cyathula officinalis Kuan Extracts on Hypertension-induced Renal Vascular Remodeling by Inhibiting the Expression of ALD, Renin, Ang II and the Activation of Erk1/2 and P38 Signaling Pathways: A Mechanistic Study

Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches

Renin Activity in Heart Failure with Reduced Systolic Function—New Insights

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