Angiotensin II as an Indicator of Left ventricular Hypertrophy in Uncontrolled Treated Hypertensive Patients

A Review on the Role of Chymase in Hypertensive Heart Disease

“…Angiotensin-II mediates vasoconstriction within the acute phase of exposure in hypertension [37], while chronicity eventually results in hypertrophy and intimal anatomical aberrations [38]. Vascular angiotensin-II is derived from circulating angiotensin-II produced by ACE [39], while the local angiotensin-II in the vessel is produced by both the ACE and Chymase [40]. Chymase activity is significant in the blood vessels following vascular injury [41].…”

“…Angiotensin-II plays a key role in homeostasis by regulating arterial tone and fluid balance [5], but becomes toxic to tissues in pathological states [6]. Angiotensin-II is the main biochemical mediator involved in LVH [7], although its inhibitors do not reduce blood pressure significantly compared to calcium channel blockers, diuretics and vasodilators [8]. This stresses on the impact of biochemical mediators causing left ventricular hypertrophy independent of the level of blood pressure.…”

“…Angiotensin-II is found in both tissues and plasma [11], with its effect varying and depending on the site and duration of action [12]. Angiotensin converting enzyme inhibitors were discovered as a result of the evidence pointing towards angiotensin-II in pathogenesis of vascular and cardiac hypertrophy [7]. Discovery of multiple antihypertensive drugs have curtailed most deleterious effects of hypertension but much requires to be done as emerging evidence prove some pitfalls in treatment strategies [13].…”