Dzau V J
Division of Vascular Medicine and Atherosclerosis, Harvard Medical School, Boston, Massachusetts 02115.
Am J Hypertens. 1988 Oct;1(4 Pt 2):334S-337S. doi: 10.1093/ajh/1.4.334s.
The traditional concept of the renin-angiotensin system (RAS) is a circulation-borne endocrine system, the components of which are secreted by various organs. The product of this biochemical cascade, angiotensin II, acts on specific receptors on multiple target organs. Activation of this circulating system has been shown to result in vasoconstriction and hypertension. In addition to this endocrine system, evidence is emerging that the renin-angiotensin system also exists at multiple local tissue sites. Recent data demonstrating that inhibitors of the RAS are capable of lowering blood pressure in the presence of suppressed as well as elevated plasma renin activity (PRA) have given rise to the hypothesis that these inhibitors exert a large part of their effect on angiotensin that is synthesized by and contained in local tissues. The concept implies that local angiotensin concentrations may exceed those of plasma levels and may play an important role in the tonic control of vascular resistance, cardiac and adrenal functions, and intrarenal events. The hypothesis could explain the broad spectrum of activity of angiotensin-converting enzyme (ACE) inhibitors in hypertensives as well as their continuing antihypertensive activity after plasma ACE levels have been restored.
肾素-血管紧张素系统（RAS）的传统概念是一种通过血液循环的内分泌系统，其组成部分由各种器官分泌。这种生化级联反应的产物血管紧张素II作用于多个靶器官上的特定受体。已证明激活这个循环系统会导致血管收缩和高血压。除了这个内分泌系统外，越来越多的证据表明肾素-血管紧张素系统也存在于多个局部组织部位。最近的数据表明，在血浆肾素活性（PRA）受到抑制以及升高的情况下，RAS抑制剂都能够降低血压，这就产生了一种假说，即这些抑制剂的大部分作用是针对由局部组织合成并存在于局部组织中的血管紧张素。这一概念意味着局部血管紧张素浓度可能超过血浆水平，并且可能在血管阻力、心脏和肾上腺功能以及肾内事件的紧张性控制中发挥重要作用。这一假说可以解释血管紧张素转换酶（ACE）抑制剂在高血压患者中的广泛活性，以及在血浆ACE水平恢复后它们持续的降压活性。
