The role of renin-angiotensin-aldosterone system in the pathogenesis of atherosclerosis. Impact on endothelial cells and accumulation of mononuclear leukocytes in the vascular wall

Abstract

Atherosclerosis is presently considered to be a type of chronic inflammatory disease in which development endothelial cell dysfunction, oxidative stress, and the fibroproliferative process within the vascular wall play very important role. Arterial hypertension, which is one of the major risk factors of atherosclerosis, may exert an important effect on many mechanisms significantly contributing to the development and progress of atherosclerosis. The article discusses in detail the role of endothelial cell dysfunction in atherosclerosis pathogenesis and mechanisms responsible for selective accumulation of mononuclear leukocytes within the vascular wall and thus for inflammation existing there. Subsequently, on the basis of the results of experimental and clinical studies, the possibilities of participation of hypertension, and in particular of angiotensin II, in these stages of development of atherosclerosis so significant for this disorder have been discussed. Morever, the article discusses how angiotensin II contributes to the intensity of inflammatory response and destabilisation of the atherosclerotic plaque and thus to the occurrence of clinical complication of atherosclerosis.