| Is the angiotensin II Type 2 receptor cerebroprotective? | |
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MedLine Citation:
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PMID: 15128469 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Most of the deleterious effects of angiotensin II (Ang II) on blood pressure (BP), cardiovascular remodeling, and atherosclerosis are mediated by Ang II type 1 (AT1)-receptor activation. This explains why Ang-II-decreasing or blocking drugs have been successful in decreasing global cardiovascular morbimortality in patients with cardiac complications. However, in primary or secondary stroke prevention trials in patients with low cardiac risk, b-blockers and angiotensin-converting enzyme inhibitors (ACEIs), which decrease Ang II formation, seem to be less protective than thiazides and dihydropyridines, which increase Ang II. When compared with a beta-blocker, an Ang II-increasing AT1-receptor blocker better protects against stroke but not against cardiac events, whereas an ACEI gives the same protection against both cardiac and cerebral events. This dissociation between blood-pressure-independent cardiac and cerebral protection between b-blockers or ACEIs versus AT1-blockers in patients with low cardiac risk can be best explained if, besides the beneficial vascular effect of AT1-receptor blunting, there is evidence of a beneficial effect of non-AT1-receptor activation. In this review, we present experimental evidence for AT2- and AT4-receptor-mediated brain-anti-ischemic mechanisms and propose a direct comparison of AT1-blockers with ACEIs to prove the clinical effectiveness of non-AT1-mediated mechanisms in stroke prevention, particularly in patients with a higher risk for stroke than for cardiac complications. |
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Authors:
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Albert Fournier; Jean Michel Achard; Florent Boutitie; Hakim Mazouz; Janette Mansour; Roxana Oprisiu; Leonardo Fernandez; Franz Messerli |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current hypertension reports Volume: 6 ISSN: 1522-6417 ISO Abbreviation: Curr. Hypertens. Rep. Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-05-06 Completed Date: 2004-09-28 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100888982 Medline TA: Curr Hypertens Rep Country: United States |
Other Details:
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Languages: eng Pagination: 182-9 Citation Subset: IM |
Affiliation:
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Service de Néphrologie, CHU SUD, Avenue René Laënnec, 80054 Amiens 1, France. fournier.albert@chu-amiens.fr |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin-Converting Enzyme Inhibitors
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therapeutic use Animals Blood Pressure / drug effects Brain / drug effects, pathology, physiopathology Brain Ischemia / physiopathology, prevention & control* Humans Receptor, Angiotensin, Type 1 / therapeutic use Receptor, Angiotensin, Type 2 / therapeutic use* Receptors, Angiotensin / therapeutic use Stroke / physiopathology, prevention & control |
| Chemical | |
Reg. No./Substance:
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0/AT4 receptor; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Receptor, Angiotensin, Type 1; 0/Receptor, Angiotensin, Type 2; 0/Receptors, Angiotensin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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