Hypertension: Kidney, Sodium, and the Renin-Angiotensin System

  • Helmy M. Siragy
  • Robert M. Carey
Part of the Atlas of Heart Diseases book series (AD)


The renin-angiotensin system is a coordinated hormonal cascade in the control of renal function, fluid and electrolyte balance, and blood pressure. Although the existence of the renin-angiotensin system has been known for over two decades, recent advances in cell and molecular biology as well as renal physiology have opened the doors for a greater understanding of the role of this system in normal and disease states. Exciting new concepts, such as molecular cloning of genes for renin, angiotensinogen, angiotensin-converting enzyme, and the angiotensin AT1 receptor, have been derived from recent studies. New angiotensin peptides with unique actions have been identified, and the role of angiotensins as cell-to-cell mediators (ie, paracrine substances) in the kidney has recently been appreciated.


Plasma Renin Activity Renal Artery Stenosis Renovascular Hypertension Efferent Arteriole Juxtaglomerular Cell 
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  1. 1.
    Griendling KK, Murphy TJ, Alexander RW: Molecular biology of the renin-angiotensin system. Circulation 1993, 87: 1816–1828.PubMedCrossRefGoogle Scholar
  2. 2.
    Brunner HR, Laragh JH, Baer L, et al.: Essential hypertension: renin and aldosterone, heart attack and stroke. N Engl J Med 1972, 286: 441–449.PubMedCrossRefGoogle Scholar
  3. 3.
    Soubrier F, Hubert C, Testut P, et al.: Molecular biology of the angiotensin I converting enzyme: 1. Biochemistry and structure of the gene. J Hypertens 1993, 11: 471–476.PubMedCrossRefGoogle Scholar
  4. 4.
    Skidgel RA, Erdos E: Angiotensin I-converting enzyme. In Hypertension Primer. Edited by Izzo J, Black HR. Dallas: American Heart Association; 1993: 12.Google Scholar
  5. 5.
    Unger T, Chung O, Csikos T, et al.: Angiotensin receptors. J Hypertens 1996, 14(suppl 5): 95–103.CrossRefGoogle Scholar
  6. 6.
    Siragy HM, Carey RM: The subtype-2 (AT2) angiotensin receptor regulates renal cyclic guanosine 3′, 5′-monophophate and AT1 receptor-mediated prostaglandin E2 production in conscious rats. J Clin Invest 1996, 97: 1978–1982.PubMedCrossRefGoogle Scholar
  7. 7.
    Siragy HM, Carey RM: The subtype 2 (AT2) angiotensin receptor mediates renal production of nitric oxide in conscious rats. J Clin Invest 1997, 100: 264–269.PubMedCrossRefGoogle Scholar
  8. 8.
    Siragy HM, Carey RM: Protective role of the angiotensin AT2 receptor in a renal wrap hypertension model. Hypertension 1999, 33: 1237–1242.PubMedCrossRefGoogle Scholar
  9. 9.
    Burnier M, Brunner HR: Renal effects of angiotensin II receptor blockade and angiotensin-converting enzyme inhibition in healthy subjects. Exp Nephrol 1996, 4(suppl 1): 41–46.PubMedGoogle Scholar
  10. 10.
    Harris RC, Cheng HF: The intrarenal renin-angiotensin system: a paracrine system for the local control of renal function separate from the systemic axis. Exp Nephrol 1996, 4(suppl 1): 2–8.PubMedGoogle Scholar
  11. 11.
    Chobanian AV: Hypertension. CIBA Found Symp 1982, 34: 3–32.Google Scholar
  12. 12.
    Hall JE, Brands MW, Shek ED: Central role of the kidney and abnormal fluid volume in hypertension. J Hum Hypertens 1996, 10: 633–639.PubMedGoogle Scholar
  13. 13.
    Goldblatt H, Lynch J, Hunzal RF, et al.: Studies in experimental hypertension: I. The production of persistent elevation of systolic blood pressure by means of renal ischemia. J Exp Med 1934, 59: 347–379.PubMedCrossRefGoogle Scholar
  14. 14.
    Laragh JH, Sealey JE, Buhler FR, et al.: The renin axis and vasoconstriction volume analysis for understanding and treating renovascular and renal hypertension. Am J Med 1975, 58: 4–13.PubMedCrossRefGoogle Scholar
  15. 15.
    Brunner HR, Kirschman JD, Sealey JE, et al.: Hypertension of renal origin: evidence for two different mechanisms. Science 1971, 174: 1344–1346.PubMedCrossRefGoogle Scholar
  16. 16.
    Gavras H, Brunner HR, Vaughan Jr ED, et al.: Angiotensin-sodium interaction in blood pressure maintenance of renal hypertensive and normotensive rats. Science 1973, 180: 1369–1371.PubMedCrossRefGoogle Scholar
  17. 17.
    Romero JC, Feldstein AE, Rodriguez-Porcel MG, et al.: New insights into the pathophysiology of renovascular hypertension. Mayo Clin Proc 1997, 72: 251–260.PubMedCrossRefGoogle Scholar
  18. 18.
    Muller SB, Sealey JE, Case DB, et al.: The Captopril test for identifying renovascular disease in hypertensive patients. Am J Med 1986, 80: 633–644.PubMedCrossRefGoogle Scholar
  19. 19.
    Kaplan NM: Systemic hypertension: mechanisms and diagnosis. In Heart Disease. Edited by Braunwald E. Philadelphia: WB Saunders; 1988: 819–883.Google Scholar
  20. 20.
    de Wardener HE, MacGregor GA: Natriuretic hormone and essential hypertension as an endocrine disease. In Essential Hypertension as an Endocrine Disease. Edited by Edwards CRW, Carey RM. London: Butterworths; 1985: 132–157.Google Scholar

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© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Helmy M. Siragy
  • Robert M. Carey

There are no affiliations available

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