Angiotensin II overproduction: enemy of the vessel wall

Unfortunately, the vessel wall has several enemies and, regrettably, overproduction of angiotensin II seems to be one of the most aggressive, often causing several principal diseases such as arteriosclerosis, hypertension, coronary artery disease and heart failure. Obviously, it is unrealistic to consider angiotensin II as the only player but, certainly, it is one of the most important, as the reduction of its overproduction by drugs such as ACE inhibitors or angiotensin II receptor blockers is able to counteract the above mentioned pathological conditions. This review mainly deals with the importance of overproduction of angiotensin II in causing endothelial dysfunction and the mechanisms which are involved, such as the activation of angiotensin I and II which have opposite effects. It is clear that a precise picture of the molecular changes induced by angiotensin II at tissue level cannot yet be described although progress is continuously made at the additive role of oxidative stress and activation of the nuclear factor kB is addressed. The mechanism of action of ACE inhibitors and the angiotensin II receptor blockers is also highlighted in the attitude which is considering the biological effect of these drugs and rather than their pharmacological effects.