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April 26, 1993

Tissue Renin-Angiotensin System in Myocardial Hypertrophy and Failure

Author Affiliations

From the Division of Cardiovascular Medicine and the Cardiovascular Research Center, Stanford University Medical Center, and the Falk Cardiovascular Research Center, Stanford, Calif.

Arch Intern Med. 1993;153(8):937-942. doi:10.1001/archinte.1993.00410080011002

The renin-angiotensin system traditionally has been conceived as a neuroendocrine system functioning in the circulation. Recent research has confirmed the existence of autocrine/ paracrine tissue renin-angiotensin systems present and functioning at multiple sites, including cardiac, vascular, and renal tissues, which contain the majority of angiotensinconverting enzyme in the body. It appears that the circulating renin-angiotensin system is activated acutely to maintain homeostasis and is then turned off at cardiovascular compensation, while the tissue renin-angiotensin systems exert long-term actions that affect cardiovascular function and structure, which may play a pathophysiological role in congestive heart failure, hypertension, and vascular disease and influence the response to therapy with angiotensin-converting enzyme-inhibiting agents.

(Arch Intern Med. 1993;153:937-942)