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2008, Número 1

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Rev Mex Cardiol 2008; 19 (1)


El sistema renina-angiotensina-aldosterona y su papel funcional más allá del control de la presión arterial

Santeliz CH, Romano EL, González CA, Hernández y HH

Idioma: Español
Referencias bibliográficas: 66
Paginas: 21-29
Archivo PDF: 503.80 Kb.


RESUMEN

A partir de que el reverendo Stephen Hales (1677-1761) realizó su publicación sobre la medición de presiones arteriales en animales en 1733, se inició el interés por medir este parámetro clínico en humanos y fue Samuel Von Basch, en 1883, quien ideó el primer sistema no invasivo para la medición de la presión arterial (el esfigmomanómetro), el cual fue modificado más tarde por Riva Rocci en 1896.
Esta forma de medición la complementó más tarde Korotkoff, patólogo ruso, quien introdujo la técnica de determinar la presión arterial por medio de la auscultación en 1905.
Este fabuloso logro de medir la presión sanguínea permitió relacionar las observaciones de Bright entre los años 1827 y 1836, sobre pacientes con riñones enfermos que presentaban anomalías cardiovasculares. Con base en estas primeras observaciones, se inició toda una cascada de estudios que trataron de determinar el papel real de la hipertensión en la salud pública; en 1913 Jeneway descubrió que ésta se asociaba a una mayor morbimortalidad relacionada principalmente con falla cardiaca, accidente cerebrovascular y uremia. Poco a poco se fue profundizando en la etiopatogenia de la hipertensión arterial y de los muchos mecanismos que contribuyen a su prevalencia. Uno de los más estudiados fue el sistema renina-angiotensina-aldosterona, el cual inclusive en la época actual no deja de sorprendernos por las nuevas implicaciones que tiene, no sólo en la presión arterial, sino también en otras vías, tanto metabólicas como proinflamatorias. En el presente artículo tratamos de englobar las funciones básicas y las nuevas funciones observadas del sistema renina angiotensina aldosterona, enfocándonos primordialmente en la Enzima Convertidora de Angiotensina (ECA), angiotensina II (AGII) y los receptores de la angiotensina tipo 1, tipo 2 y tipo 4 (AT-1, AT-2, y AT-4 respectivamente).


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