Role of the Renin-Angiotensin-Aldosterone System in the Pathogenesis of Atherosclerosis

Alessandro      Durante; Giovanni      Peretto; Alessandra      Laricchia; Francesco      Ancona; Marco      Spartera; Antonio      Mangieri; Domenico      Cianflone

Abstract

Renin-Angiotensin-Aldosterone (RAAS) is a hormone system which acts on multiple physiologic pathways primarily by regulating blood pressure and fluid balance, but also by local autocrine and paracrine actions. In pathophysiologic conditions RAAS also contributes to the development of atherosclerosis and its various manifestations, both directly and indirectly through the actions on other systems. RAAS mainly acts as a promoter of atherosclerosis by its action on vessels, and by promoting the developmentt of hypertension, insulin resistance and diabetes, obesity, vascular and systemic inflammation. As RAAS plays a key role in the pathogenesis of cardiovascular diseases, RAAS genes have been extensively studied as candidate genes for atherosclerosis and coronary artery disease. Several polymorphisms of its genes have been found to be in relationship with atherosclerosis and cardiovascular diseases. In this review we will discuss these issues and present the most recent advances about this topic.

Keywords: Renin, angiotensin, aldosterone, RAAS, atherosclerosis, blood pressure, fluid balance, coronary artery disease, juxtaglomerular cells, prostaglandins