Pharmacological Interruption Of The Renin System And The Kidney: Lessons From Comparative Pharmacology

  • Norman K. Hollenberg
Part of the Progress in Experimental Cardiology book series (PREC, volume 2)


Pharmacological interruption of the renin system has played a crucial role in our understanding of this system’s contribution to normal physiological processes and in the pathogenesis of disease. Blocking the system pharmacologically is a crucial line of investigation, a function ordinarily played by glandular ablation and hormone replacement. The pharmacological agents, on the other hand, are often plagued by actions which contribute to ambiguity. In the case of the renin system, the angiotensin-converting enzyme (ACE) inhibitors have multiple additional actions beyond blocking angiotensin (Ang) II formation, including kinin formation and consequent promotion of nitric oxide and vasodilator prostag-landin release. The development of Ang II antagonists and renin inhibitors has provided pharmacological alternatives and improved information on specificity of action. Although concern has been expressed that the alternatives to ACE inhibition may lack some therapeutic features, it is suspected that blockade at the renin or the Ang II receptor levels will block the system more effectively, and thus may provide a positive alternative. The renin inhibitor is more effective because the interaction of renin with its substrate is a rate-limiting step in the process. The possibility that non-renin—non-ACE dependent Ang II generation contributes to blocking the Ang II receptor is real and will be the subject of substantial investigation in the near future.


Renal Blood Flow Resistant Hypertension Renin Inhibitor High Salt Diet Renal Response 
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Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Norman K. Hollenberg
    • 1
  1. 1.Brigham and Women’s Hospital and Harvard Medical SchoolBostonUSA

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