engleski

RAS- THE GOOD, THE BAD, AND THE UGLY: SHOULD ANTIHYPERTENSIVE THERAPY BE TAILORED INDIVIDUALLY?

The renin-angiotensin system (RAS) is crucial in maintaining body fluid volume and blood pressure during changes in salt and water intake, and is also an important mediator of both systemic and local vascular control. Activation of RAS could have a detrimental role in various cardiovascular diseases that could be prevented by drugs interfering with the RAS function. On the other hand, a growing body of evidence suggests that the normally functioning RAS has a protective effect in the maintenance of vascular structure and function, effect which is even independent of the blood pressure levels. Suppression of RAS results in impaired vascular / endothelial function and may have potentially harmful effect on the overall control of circulation. Underlying mechanism affected by RAS is control of the local vascular oxidative stress, which is increased in both hyperfunctioning and hypofunctioning RAS, leading to vascular dysfunction, increased vascular resistance and hypertension. Thus, one may consider tailoring of the antihypertensive therapy individually, after well characterization of the RAS activity and with defined salt-sensitivity of the blood pressure.

renin-angiotensin system; hypertension; antihypertensive therapy

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