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[object Object],[object Object],Renin-Angiotensin system   “Progress in the future”
 
Renin Angiotensin System (RAS) overview Renin-angiotensin system and cardiovascular risk  Lancet 2007; 369: 1208–19
 
Cell surface receptors of RAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Renin-angiotensin system and cardiovascular risk  Lancet 2007; 369: 1208–19
Cell surface receptors of RAS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Renin-angiotensin system and cardiovascular risk  Lancet 2007; 369: 1208–19
Cell surface receptors of RAS ,[object Object],[object Object],[object Object],[object Object],Renin-angiotensin system and cardiovascular risk  Lancet 2007; 369: 1208–19
 
Angiotensin Receptor 1 (AT1) http://www.mpi-magdeburg.mpg.de/research/projects/1010/1014/neuron_modeling
Nature Reviews Drug Discovery   1 ; 621-636 (2002); doi:10.1038/nrd873
RAS and NOS Angiotensin II-nitric oxide interaction in the kidney  Current Opi Nephrol Hypertens  16:61-51,2007
RAS and sympathetic regulation
 
What’s the relationship ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RAS and Left Ventricular Hypertrophy
Left ventricular hypertrophy ,[object Object],[object Object],[object Object]
Reduction of left ventricular mass ,[object Object]
Reduction of left ventricular mass ,[object Object],[object Object],[object Object]
RAS and Atrial fibrillation
Risk of Atrial fibrillation Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure  Journal of Hypertension 2007, 25:15–23
Large hypertension (HT) and heart failure (CHF) trials reporting new-onset atrial fibrillation Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure  Journal of Hypertension 2007, 25:15–23
Preventive effects of angiotensin II-receptor blockers Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure  Journal of Hypertension 2007, 25:15–23
Meta-analysis: Inhibition of renin-angiotensin system prevents new-onset atrial fibrillation Meta-analysis: Inhibition of renin-angiotensin system prevents new-onset atrial fibrillation (Am Heart J 2006;152:217222.)
Forest plot and RR of individual trial and summary pooled estimate. Meta-analysis: Inhibition of renin-angiotensin system prevents new-onset atrial fibrillation (Am Heart J 2006;152:217222.)
Conclusion ,[object Object],Meta-analysis: Inhibition of renin-angiotensin system prevents new-onset atrial fibrillation (Am Heart J 2006;152:217222.)
Possible preventive mechanisms Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure  Journal of Hypertension 2007, 25:15–23
RAS and Stroke
Angiotensin and stoke Hypertension, Angiotensin, and Stroke: Beyond Blood Pressure ( Stroke  February 2004)
AT1 and AT2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
AT4 ,[object Object],(Cerebroprotective effect of  angiotensin  IV in experimental ischemic stroke in the rat mediated by AT(4) receptors. Journal of Physiology & Pharmacology. 57(3):329-42, 2006 Sep. )
ACEI,ARB , diuretics, Beta-Blocker in Stroke ,[object Object],[object Object],[object Object]
Cumulative incidence of cerebrovascular events (secondary endpoint) in patients in the MOSES study
Summary for stroke ,[object Object],[object Object]
RAS and Atherosclerosis
Renin-angiotensin system and atherosclerosis
Mechanism of Atherosclerosis ,[object Object],[object Object],[object Object],[object Object]
Angiotensin II and Interleukin-18  ( Circ Res . 2005;96:1064-1071.)
[object Object]
[object Object]
Angiotensin and atheroslcerosis Hypertension, Angiotensin, and Stroke: Beyond Blood Pressure ( Stroke  February 2004)
Comparison of three large scale clinical trials examining the effect of ACE inhibition on cardiovascular events
Renin Angiotensin system and type 2 diabetes
[object Object],[object Object],[object Object],[object Object]
New-onset diabetes in comparative outcome trials involving the use of RAS blockade versus non-RAS blockade Why blockade of the renin–angiotensin system reduces the incidence of new-onset diabetes (Journal of Hypertension 2005, Vol 23 No 3 )
The Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication trial ,[object Object]
Risk of developing type 2 diabetes with ACE inhibitors or ARBs compared with other antihypertensive treatment
Change of albuminuria predicts occurrence of cardiovascular events and heart failure in patients with overt diabetic nephropathy Reproduced with permission from de Zeeuw D et al. Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy.  Circulation  2004;  110:  921–27.143
T hanks for your attention
Exocytose by Angiotensin II Involves Multiple G-Protein-Regulated Transduction Pathways in Chromaffin Cells The Journal of Neuroscience, July 1, 2000,  20 (13):4776–4785

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Renin-Angiotensin Aldosterone system

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  • 11. RAS and NOS Angiotensin II-nitric oxide interaction in the kidney Current Opi Nephrol Hypertens 16:61-51,2007
  • 12. RAS and sympathetic regulation
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  • 19. RAS and Atrial fibrillation
  • 20. Risk of Atrial fibrillation Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure Journal of Hypertension 2007, 25:15–23
  • 21. Large hypertension (HT) and heart failure (CHF) trials reporting new-onset atrial fibrillation Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure Journal of Hypertension 2007, 25:15–23
  • 22. Preventive effects of angiotensin II-receptor blockers Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure Journal of Hypertension 2007, 25:15–23
  • 23. Meta-analysis: Inhibition of renin-angiotensin system prevents new-onset atrial fibrillation Meta-analysis: Inhibition of renin-angiotensin system prevents new-onset atrial fibrillation (Am Heart J 2006;152:217222.)
  • 24. Forest plot and RR of individual trial and summary pooled estimate. Meta-analysis: Inhibition of renin-angiotensin system prevents new-onset atrial fibrillation (Am Heart J 2006;152:217222.)
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  • 26. Possible preventive mechanisms Prevention of new-onset atrial fibrillation and its predictors with angiotensin II-receptor blockers in the treatment of hypertension and heart failure Journal of Hypertension 2007, 25:15–23
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  • 41. Comparison of three large scale clinical trials examining the effect of ACE inhibition on cardiovascular events
  • 42. Renin Angiotensin system and type 2 diabetes
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  • 44. New-onset diabetes in comparative outcome trials involving the use of RAS blockade versus non-RAS blockade Why blockade of the renin–angiotensin system reduces the incidence of new-onset diabetes (Journal of Hypertension 2005, Vol 23 No 3 )
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  • 46. Risk of developing type 2 diabetes with ACE inhibitors or ARBs compared with other antihypertensive treatment
  • 47. Change of albuminuria predicts occurrence of cardiovascular events and heart failure in patients with overt diabetic nephropathy Reproduced with permission from de Zeeuw D et al. Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy. Circulation 2004; 110: 921–27.143
  • 48. T hanks for your attention
  • 49. Exocytose by Angiotensin II Involves Multiple G-Protein-Regulated Transduction Pathways in Chromaffin Cells The Journal of Neuroscience, July 1, 2000, 20 (13):4776–4785