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| Slide Lecture Programs |
| 2000 Core Curriculum |
| The endothelium: New insights into the origins and treatment of CAD |
August 31, 2000
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| II: |
Interactions of the RAS: ACE and the angiotensin II and bradykinin pathways |
Slide 31 |
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ACE inhibitors and fibrinolysis
- The tissue RAS and circulating RAS work with the fibrinolytic system to maintain a smoothly functioning cardiovascular system.30
- Bradykinin and Ang II compete at the level of vasoconstriction. Ang II is a potent vasoconstrictor and bradykinin is a potent vasodilator.
- Bradykinin is probably the most potent stimulus for the production and secretion of tissue plasminogen activator (t-PA). In contrast, Ang II is an extremely powerful stimulus for the production and secretion of plasminogen activator inhibitor 1 (PAI-I). These two peptides compete at the vascular interface to determine net fibrinolytic balance.
- The action of ACE inhibitors to elevate bradykinin and decrease Ang II would be expected to promote higher levels of t-PA and decrease PAI-I levels, thereby enhancing fibrinolysis.
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