RAAS
The RAAS helps in regulating blood pressure and fluid balance. In heart failure, the reduced cardiac output and systemic blood pressure stimulate the RAAS as a compensatory mechanism, which in turn leads to increased retention of sodium and water, vasoconstriction, and elevated blood pressure. This activation of the RAAS is at first adaptive, but it basically contributes to the progression of heart failure and exacerbates atherosclerosis by promoting endothelial dysfunction, inflammation, and vascular remodeling.
It works this way: in response to heart failure, the RAAS system is activated as a compensatory mechanism (Pugliese et al., 2020). The process begins when the kidneys, sensing reduced blood flow and pressure, release the enzyme renin into the bloodstream. Renin converts angiotensinogen, a liver-produced protein, into angiotensin I, which is then converted into angiotensin II by angiotensin-converting enzyme (ACE) primarily in the lungs. Angiotensin II is a potent vasoconstrictor, which increases blood pressure by narrowing blood vessels (Senatore et al., 2021). Additionally, it stimulates the secretion of aldosterone from the adrenal glands, leading to sodium and water retention by the kidneys, thereby increasing blood volume...
Chronic vasoconstriction and fluid retention elevate...…and atherosclerosis has led to the development of therapeutic strategies aimed at inhibiting this system to improve outcomes in patients with cardiovascular diseases. Medications such as ACE inhibitors, angiotensin II receptor blockers (ARBs), and mineralocorticoid receptor antagonists (MRAs) target different components of the RAAS, offering benefits such as reduced blood pressure, decreased risk of atherosclerotic events, and mitigation of heart failure progression.Overall, the RAAS is important in the body's initial response to heart failure, but its chronic activation contributes significantly to the pathology of heart failure and atherosclerosis through mechanisms such as endothelial dysfunction, inflammation, and vascular remodeling. Targeting the RAAS therapeutically has become a cornerstone in managing these conditions, which shows the…
References
Laranjo, L., Lanas, F., Sun, M. C., Chen, D. A., Hynes, L., Imran, T. F., ... & Chow, C. K.
(2024). World Heart Federation Roadmap for Secondary Prevention of Cardiovascular Disease: 2023 Update. Global Heart, 19(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10809857/
Pugliese, N. R., Masi, S., & Taddei, S. (2020). The renin-angiotensin-aldosterone system: acrossroad from arterial hypertension to heart failure. Heart Failure Reviews, 25, 31-42.
Romero-González, G., Rodríguez-Chitiva, N., Cañameras, C., Paúl-Martínez, J., Urrutia-Jou, M.,Troya, M., ... & Bover, J. (2024). Albuminuria, Forgotten No More: Underlining the Emerging Role in CardioRenal Crosstalk. Journal of Clinical Medicine, 13(3), 777. https://doi.org/10.3390/jcm13030777
Senatore, F., Balakumar, P., & Jagadeesh, G. (2021). Dysregulation of the renin-angiotensinsystem in septic shock: mechanistic insights and application of angiotensin II in clinical management. Pharmacological Research, 174, 105916.
Heart Failure Guidelines The 2009 revision of the ACC/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults contains a number of evidence-based updates, revised text, and a new section called "hospitalized patient" (Hunt et al. e395). These revisions are the result of a task force that convened in 2008 and represent new findings published between 2005 and 2008. Four stages along a continuum of heart failure are described, with
Heart failure has been described as a "complex clinical syndrome that results from either structural or functional impairment of ventricular filling or ejection," (Alspach, 2014, p. 1). Because of the multifaceted nature of heart failure, it is important to recognize its various symptoms and dimensions. Heart failure in general presents a major public health concern, with current prevalence at over five million adults in the United States and over 650,000
Heart Failure Literature Critique of Articles concerning Heart Failure The two articles in this literature review are concerned with different aspects of care for patients diagnosed with some stage of heart failure (HF). Heart failure is one of the most prevalent and debilitating diseases worldwide and is the leading cause for hospitalizations for people older than 65 years (Schwarz, Mion, Hudock & Litman, 2007). These two articles look at ways of
M.K., a 45-year-old female who has a history of Type II diabetes mellitus and primary hypertension. In addition to this, M.K. is overweight and persists with a poor diet. The patient has also been smoking for the past 22 years, and has recently been diagnosed with chronic bronchitis. Current symptoms include chronic cough, which tends to be more severe in the mornings and productive with sputum, light-headedness, distended neck
Treatment of Heart Failure in Nursing Home Residents Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF
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