Alreja G, Joseph J. Renin and cardiovascular disease: Worn-out path, or new direction. World J Cardiol 2011; 3(3): 72-83 [PMID: 21499495 DOI: 10.4330/wjc.v3.i3.72]
Corresponding Author of This Article
Jacob Joseph, MD, Cardiology Section (111), VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA 02132, United States. jjoseph16@partners.org
Article-Type of This Article
Editorial
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World J Cardiol. Mar 26, 2011; 3(3): 72-83 Published online Mar 26, 2011. doi: 10.4330/wjc.v3.i3.72
Renin and cardiovascular disease: Worn-out path, or new direction
Gaurav Alreja, Jacob Joseph
Gaurav Alreja, Jacob Joseph, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, United States
Jacob Joseph, Cardiology Section (111), VA Boston Healthcare System, West Roxbury, MA 02132, United States
Jacob Joseph, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, United States
Author contributions: Alreja G reviewed the literature and wrote the article; Joseph J reviewed the literature and revised the article.
Supported by (in part) a research grant from Novartis Pharmaceuticals to Joseph J
Correspondence to: Jacob Joseph, MD, Cardiology Section (111), VA Boston Healthcare System, 1400 VFW Parkway, West Roxbury, MA 02132, United States. jjoseph16@partners.org
Telephone: +1-857-2035111 Fax: +1-857-2035549
Received: January 15, 2011 Revised: March 2, 2011 Accepted: March 9, 2011 Published online: March 26, 2011
Abstract
Inhibition of the renin angiotensin system has beneficial effects in cardiovascular prevention and treatment. The advent of orally active direct renin inhibitors adds a novel approach to antagonism of the renin-angiotensin system. Inhibition of the first and rate-limiting step of the renin angiotensin cascade offers theoretical advantages over downstream blockade. However, the recent discovery of the (pro)renin receptor which binds both renin and prorenin, and which can not only augment catalytic activity of both renin and prorenin in converting angiotensinogen to angiotensin I, but also signal intracellularly via various pathways to modulate gene expression, adds a significant level of complexity to the field. In this review, we will examine the basic and clinical data on renin and its inhibition in the context of cardiovascular pathophysiology.
