Key result
Renin-angiotensin system modulation confers neuroprotective effects in stroke independent of blood pressure lowering.
Why the study?
Hypertension is the leading stroke risk factor and the renin-angiotensin system is involved in stroke physiopathology, motivating a review of its role in stroke neuroprotection.
Do renin-angiotensin system modulators provide neuroprotection in stroke independently of their blood-pressure-lowering effects?
Systematic Review
Do renin-angiotensin system modulators provide neuroprotection in stroke independently of their blood-pressure-lowering effects?
Modulation of the renin-angiotensin system, particularly through AT2 and Mas receptors, offers promising neuroprotective effects in stroke beyond conventional blood pressure control.
May support ARB use for stroke neuroprotection beyond BP lowering; extends mechanistic evidence on AT2/Mas pathways for targeted trials.
Stroke is the primary cause of disability in the adult population. Hypertension represents the leading risk factor being present in almost half the patients. The renin-angiotensin system is involved in the physiopathology of stroke and has an essential impact on hypertension as a risk factor. This article targeted the role of the renin-angiotensin system in stroke neuroprotection by reviewing the current literature available. The mechanism of action of the renin-angiotensin system was observed through the effects on AT1, AT2, and Mas receptors. The neuroprotective properties ascertained by angiotensin in stroke seem to be independent of the blood pressure reduction mechanism, and include neuroregeneration, angiogenesis, and increased neuronal resistance to hypoxia. The future relationship of stroke and the renin-angiotensin system is full of possibilities, as new agonist molecules emerge as potential candidates to restrict the impairment caused by stroke.
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Andone et al. (2022) conducted a systematic review in Stroke. Renin-angiotensin system modulators vs. Placebo, active comparators, or unexposed controls was evaluated. The renin-angiotensin system exhibits neuroprotective properties in stroke, such as neuroregeneration and angiogenesis, which appear to be independent of the blood pressure reduction mechanism.
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