Beyond Angiotensin-Converting Enzyme Inhibitors: Modulation of the Renin-Angiotensin-Aldosterone System to Delay or Manage Congestive Heart Failure

Marisa K Ames; Darcy B Adin; James Wood

doi:10.1016/j.cvsm.2023.05.015

Beyond Angiotensin-Converting Enzyme Inhibitors: Modulation of the Renin-Angiotensin-Aldosterone System to Delay or Manage Congestive Heart Failure

Vet Clin North Am Small Anim Pract. 2023 Nov;53(6):1353-1366. doi: 10.1016/j.cvsm.2023.05.015. Epub 2023 Jul 7.

Authors

Marisa K Ames¹, Darcy B Adin², James Wood³

Affiliations

¹ Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, CA 95616, USA. Electronic address: mkames@ucdavis.edu.
² University of Florida, College of Veterinary Medicine, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA.
³ Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California - Davis, 1 Shields Avenue, Davis, CA 95616, USA.

PMID: 37423846
DOI: 10.1016/j.cvsm.2023.05.015

Abstract

The renin-angiotensin-aldosterone system (RAAS) consists of bioactive angiotensin peptides, enzymatic pathways, receptors, and the steroid hormone aldosterone. The RAAS regulates blood pressure, sodium, and electrolyte homeostasis and mediates pathologic disease processes. Within this system is an alternative arm that counterbalances the vasoconstrictive, sodium and water retentive, and pro-fibrotic and inflammatory effects of the classical arm. Improved biochemical methodologies in RAAS quantification are elucidating how this complex system changes in health and disease. Future treatments for cardiovascular and kidney disease will likely involve a more nuanced manipulation of this system rather than simple blockade.

Keywords: Angiotensin 1,7; Angiotensin converting enzyme inhibitor; Angiotensin receptor blocker; Angiotensin-converting enzyme 2; Diuretics; Mineralocorticoid receptor antagonist.

Publication types

Review

MeSH terms

Angiotensin-Converting Enzyme Inhibitors* / therapeutic use
Animals
Cat Diseases* / drug therapy
Cat Diseases* / physiopathology
Cats
Dog Diseases* / drug therapy
Dogs
Heart Failure* / drug therapy
Heart Failure* / prevention & control
Heart Failure* / veterinary
Renin-Angiotensin System* / drug effects
Renin-Angiotensin System* / physiology

Substances

Angiotensin-Converting Enzyme Inhibitors