There are different factors that play a role in managing blood pressure including, genetics and inappropriate release of certain hormones from the kidneys, specifically the renin-angiotensin-aldosterone system (RAAS).
There are 3 major triggers that influence the body to increase blood pressure and they are very intuitive: mechanical, neurological, and chemical. All 3 of these triggers signal the release of renin. This is how the system works-
First, the liver releases angiotensinogen
Renin converts angiotensinogen to angiotensin
Angiotensin Converting Enzyme or (ACE) converts angiotensin 1 to angiotensin 2.
Angiotensin Converting Enzyme also has an additional role in inactivating bradykinin. Bradykinin is an endothelium-dependant vasodilator and a mild diuretic that can help lower blood pressure.
Angiotensin 2 then binds to AT1 receptors.
This leads to vasoconstriction and the release of aldosterone. Aldosterone balances sodium and potassium in the body. However, large amounts of this hormone can cause an increase in blood pressure.
High blood pressure can decrease perfusion or blood flow to the kidneys causing an inappropriate release of renin.
Three different classes of medications are used to disrupt this cycle of inappropriate renin release- Renin inhibitors, ACE inhibitors, and ARBs.
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