Experimental and clinical evidence that angiotensin II is an independent risk factor for cardiovascular disease

The role of the renin–angiotensin system in the regulation of normal blood pressure and in the pathogenesis of hypertension has long been appreciated. Angiotensin II (Ang II) was originally thought to only influence blood pressure, but the results of many preclinical and clinical studies now suggest that Ang II has an important and distinct role in other cardiovascular pathologies. Drugs that interfere with the renin–angiotensin system, such as angiotensin-converting enzyme (ACE) inhibitors, are now widely accepted for the treatment of chronic renal failure and heart failure. Recent studies have shown that Ang II acts directly on the myocardium to cause ventricular hypertrophy, a response that can be prevented or reversed by selective Ang II type 1 receptor antagonists. The utility of angiotensin receptor antagonists in the treatment of chronic renal failure has been demonstrated, and the results of ongoing clinical trials can be expected to prove their benefit in other cardiovascular pathologies.