Arterial hypertension is a common condition worldwide and an important predictor of several complicated diseases. Arterial hypertension can be triggered by many factors, including physiological, genetic, and lifestyle causes. Specifically, molecules of the renin-angiotensin-aldosterone system not only play important roles in the control of blood pressure, but they are also associated with the genesis of arterial hypertension, thus constituting a need for pharmacological interventions. Chronic high pressure generates mechanical damage along the vascular system, heart, and kidneys, which are the principal organs affected in this condition. In addition to mechanical stress, hypertension-induced oxidative stress, chronic inflammation, and the activation of reparative mechanisms lead to end-organ damage, mainly due to fibrosis. Clinical trials have demonstrated that renin-angiotensin-aldosterone system intervention in hypertensive patients lowers morbidity/mortality and inflammatory marker levels as compared to placebo patients, evidencing that this system controls more than blood pressure. This review emphasizes the detrimental effects that a renin-angiotensin-aldosterone system (RAAS) imbalance has on health considerations above and beyond high blood pressure, such as fibrotic end-organ damage.

We studied the influence of captopril, atenolol, and verapamil on serum and intraerythrocyte concentrations of magnesium and zinc in 30 normotensive control subjects (12 men and 18 women, aged 30 to 65 years, mean +/- SD 45.76 +/- 12.15 years) and 30 patients with untreated mild or moderate essential hypertension (14 men and 16 women, aged 30 to 65 years, mean +/- SD 49.50 +/- 13.58 years). Ten each of the hypertensive patients were treated with captopril, atenolol, or verapamil. Physical examination and biochemical analyses (serum Mg and Zn) were done in all participants at baseline, and in patients after 3 and 6 months of treatment. The results were compared according to a nested design with Neumann-Keuls test. We found no significant differences between controls and patients in serum and intraerythrocyte concentrations of Zn at the start of the study, although there was a significant decrease in serum Zn in patients after 3 (P < .01) and 6 months (P < .001) of treatment, regardless of the drug used. This decrease was thought to be attributable to the zincuric effect of captopril or to dietary measures, or both. Intraerythrocyte Zn was not significantly affected by antihypertensive treatment. Serum and intraerythrocyte concentrations of Mg were significantly lower (P < .001) in hypertensive than in normotensive subjects, and serum Mg in patients treated with verapamil was significantly lower (P < .05) than after treatment with captopril or atenolol. Serum Mg concentration was related directly with serum concentrations of high density lipoprotein cholesterol (r = 0.4043, P < .05). We conclude that supplementation with Mg may benefit patients with hypertension.

Background We aimed to study the associations of adipocytokines, endothelial damage markers, and hs-CRP with metabolic syndrome (MetS) components. Methods This cross-sectional study included 202 subjects categorized into MetS and No-MetS according to Harmonizing ATP III. Results Subjects with MetS showed higher levels of pro-inflammatory molecules but significantly lower adiponectin levels than subjects with No-MetS. Among the studied adipocytokines, PAI-1 and adiponectin showed the strongest associations with most MetS components. PAI-1 was associated with MetS (OR 1.107 [1.065 – 1.151], p&lt;0.0001), whereas adiponectin was inversely associated with MetS (OR 0.710 [0.610 – 0.825], p&lt;0.0001). Following adjustment by sex, age, BMI, and 24 h urinary sodium excretion in a multivariate analysis, the association of PAI-1 (OR 1.090 [1.044 - 1.137], p&lt;0.0001) and adiponectin (OR 0.634 [0.519 – 0.775], p&lt;0.0001) with MetS remained significant. Multivariate analyses supported a model in which systolic blood pressure could be predicted by PAI-1, hsCRP, and MMP2 (R2 = 0.125; p = 0.04); diastolic blood pressure (R2 = 0.218; p=0.0001) and glucose (R2 = 0.074; p=0.0001) could be predicted by PAI-1; waist circumference could be predicted by PAI-1 and hsCRP (R2=0.28; p = 0.016). ROC curve analysis showed that a PAI-1 concentration had the best sensitivity and specificity for discriminating subjects with MetS. Conclusion PAI-1 and adiponectin rendered the most robust associations with MetS components in a general population, indicating that unfavorable adipose tissue performance is a key contributor to these metabolic anomalies. Further prospective analyses should allow establishing whether these adipocytokines can anticipate the progress of MetS and cardiovascular risk.