Dual Blocking of the Renin Angiotensin System: A Settled Issue?

The renin angiotensin system (RAS) plays an all-encompassing role in cardiovascular regulation. Indeed, the early notion defining its function as vasoconstrictive was expanded to a much broader physiological spectrum, including sodium regulation and structural cardiovascular changes. Moreover, many studies have shown the synthesis and release of various components of the RAS in a number of organs. Further research revealed disparate RAS effects on vascular tone and sodium excretion. That is, RAS can induce vasoconstriction or vasodilatation, natriuresis or sodium retention, hypertrophy or decreased proliferation, all depending on a diversity of angiotensin peptides that can bind to different receptors. The complexity of this system explains the multiplicity of its effects.