Role of the central renin‑angiotensin system in hypertension (Review)
- PMID: 33846799
- PMCID: PMC8041481
- DOI: 10.3892/ijmm.2021.4928
Role of the central renin‑angiotensin system in hypertension (Review)
Abstract
Present in more than one billion adults, hypertension is the most significant modifiable risk factor for mortality resulting from cardiovascular disease. Although its pathogenesis is not yet fully understood, the disruption of the renin‑angiotensin system (RAS), consisting of the systemic and brain RAS, has been recognized as one of the primary reasons for several types of hypertension. Therefore, acquiring sound knowledge of the basic science of RAS and the underlying mechanisms of the signaling pathways associated with RAS may facilitate the discovery of novel therapeutic targets with which to promote the management of patients with cardiovascular and kidney disease. In total, 4 types of angiotensin II receptors have been identified (AT1R‑AT4R), of which AT1R plays the most important role in vasoconstriction and has been most extensively studied. It has been found in several regions of the brain, and its distribution is highly associated with that of angiotensin‑like immunoreactivity in nerve terminals. The effect of AT1R involves the activation of multiple media and signaling pathways, among which the most important signaling pathways are considered to be AT1R/JAK/STAT and Ras/Raf/MAPK pathways. In addition, the regulation of the nuclear factor κ‑light‑chain‑enhancer of activated B cells (NF‑κB) and cyclic AMP response element‑binding (CREB) pathways is also closely related to the effect of ATR1. Their mechanisms of action are related to pro‑inflammatory and sympathetic excitatory effects. Central AT1R is involved in almost all types of hypertension, including spontaneous hypertension, salt‑sensitive hypertension, obesity‑induced hypertension, renovascular hypertension, diabetic hypertension, L‑NAME‑induced hypertension, stress‑induced hypertension, angiotensin II‑induced hypertension and aldosterone‑induced hypertension. There are 2 types of central AT1R blockade, acute blockade and chronic blockade. The latter can be achieved by chemical blockade or genetic engineering. The present review article aimed to highlight the prevalence, functions, interactions and modulation means of central AT‑1R in an effort to assist in the treatment of several pathological conditions. The identification of angiotensin‑derived peptides and the development of AT‑2R agonists may provide a wider perspective on RAS, as well as novel therapeutic strategies.
Keywords: renin‑angiotensin system; angiotensin II; AT‑1R; hypertension.
Conflict of interest statement
The authors declare that they have no competing interests.
Similar articles
-
Combined Angiotensin Receptor Modulation in the Management of Cardio-Metabolic Disorders.Drugs. 2016 Jan;76(1):1-12. doi: 10.1007/s40265-015-0509-4. Drugs. 2016. PMID: 26631237 Free PMC article. Review.
-
AT2 Receptors: Potential Therapeutic Targets for Hypertension.Am J Hypertens. 2017 Apr 1;30(4):339-347. doi: 10.1093/ajh/hpw121. Am J Hypertens. 2017. PMID: 27664954 Review.
-
Angiotensin II signaling via type 2 receptors in a human model of vascular hyporeactivity: implications for hypertension.J Hypertens. 2010 Jan;28(1):111-8. doi: 10.1097/HJH.0b013e328332b738. J Hypertens. 2010. PMID: 19797979
-
Novel Interactions Involving the Mas Receptor Show Potential of the Renin-Angiotensin system in the Regulation of Microglia Activation: Altered Expression in Parkinsonism and Dyskinesia.Neurotherapeutics. 2021 Apr;18(2):998-1016. doi: 10.1007/s13311-020-00986-4. Epub 2021 Jan 20. Neurotherapeutics. 2021. PMID: 33474655 Free PMC article.
-
Angiotensin II type 2 receptors contribute to vascular responses in spontaneously hypertensive rats treated with angiotensin II type 1 receptor antagonists.Am J Hypertens. 2005 Apr;18(4 Pt 1):493-9. doi: 10.1016/j.amjhyper.2004.11.007. Am J Hypertens. 2005. PMID: 15831358
Cited by
-
Modulatory Effects of the Kuwanon-Rich Fraction from Mulberry Root Bark on the Renin-Angiotensin System.Foods. 2024 May 16;13(10):1547. doi: 10.3390/foods13101547. Foods. 2024. PMID: 38790847 Free PMC article.
-
Esaxerenone, organ protection without sympathetic activation.Hypertens Res. 2024 Oct;47(10):2923-2925. doi: 10.1038/s41440-024-01809-1. Epub 2024 Aug 8. Hypertens Res. 2024. PMID: 39117949 No abstract available.
-
Angiotensin II induces endothelial dysfunction and vascular remodeling by downregulating TRPV4 channels.J Mol Cell Cardiol Plus. 2023 Dec;6:100055. doi: 10.1016/j.jmccpl.2023.100055. Epub 2023 Nov 19. J Mol Cell Cardiol Plus. 2023. PMID: 38333200 Free PMC article.
-
Mineralocorticoid Receptor Activation in Vascular Insulin Resistance and Dysfunction.Int J Mol Sci. 2022 Aug 11;23(16):8954. doi: 10.3390/ijms23168954. Int J Mol Sci. 2022. PMID: 36012219 Free PMC article. Review.
-
Angiotensin II, blood-brain barrier permeability, and microglia interplay during the transition from pre-to hypertensive phase in spontaneously hypertensive rats.Front Physiol. 2024 Sep 12;15:1452959. doi: 10.3389/fphys.2024.1452959. eCollection 2024. Front Physiol. 2024. PMID: 39328833 Free PMC article.
References
-
- Schaeffer C, Izzi C, Vettori A, Pasqualetto E, Cittaro D, Lazarevic D, Caridi G, Gnutti B, Mazza C, Jovine L, et al. Autosomal dominant tubulointerstitial kidney disease with adult onset due to a novel renin mutation mapping in the mature protein. Sci Rep. 2019;9:11601. doi: 10.1038/s41598-019-48014-6. - DOI - PMC - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical
Research Materials
Miscellaneous