Angiotensins are peptide hormones derived from the protein precursorangiotensinogen by the sequential actions of proteolytic enzymes(Figure 1). The classic pathway of angiotensin synthesis includesa reaction catalyzed by angiotensin-converting enzyme (ACE),which occurs not only in plasma but also in the kidneys, brain,adrenal glands, ovaries, and possibly other tissues.1 The intrarenalreninangiotensin system affects glomerular filtration,as discussed below, but the importance of angiotensin synthesisin other tissues is not known. Angiotensin II, the principaleffector of the reninangiotensin cascade, can also besynthesized by a pathway that does not require ACE.2
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Regulation of Angiotensin Receptors and Their Actions
Angiotensin Receptors in Growth and Development
Mechanism of Action of Angiotensin-Receptor Antagonists
Clinical Trials of Angiotensin-Receptor Antagonists
Efficacy in Treating Hypertension
Renal Effects
Heart Failure and Hypertrophy
Endocrine and Metabolic Effects
Speculations and Uncertainties
Source Information
From the William S. Middleton Memorial Veterans Hospital and the Departments of Medicine and Pharmacology, School of Medicine, University of Wisconsin, Madison (T.L.G., M.E.E.); and the Endocrinology and Reproduction Research Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Md. (K.J.C.).
Address reprint requests to Dr. Goodfriend at the William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terr., Madison, WI 53705.
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