Word: angiotensin
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Dates: during 2000-2009
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...began tackling the condition aggressively, and as the percentage of people being treated crept up, the incidence of hypertension-related conditions fell. Strokes alone declined more than 50% from 1972 to 1994. Clearly, the country was closing in on a big medical win--with medications like beta blockers and angiotensin-converting enzyme (ACE) inhibitors making big contributions to that success. But the ball has been dropped, and the reasons, in retrospect, are clear...
...kidneys work hard to keep that from happening. If salt content is too high, the body's water content will be elevated too. The system responds by slowing down the manufacture of renin, an enzyme that increases water retention. Dialing back the renin also dials back the production of angiotensin, a protein that constricts blood vessels. Should the salt level fall too far, the body reverses the procedure, cranking up renin to hold on to water and releasing angiotensin to tighten vessels. There are a lot of things that can throw that system off, including kidney disease and tumors...
...survive the murderous journey without succumbing to thirst but predisposed their descendants to hypertension. Dr. Lawrence Appel of the Johns Hopkins University School of Med-icine believes that modern-day African Americans do process sodium a bit differently from whites and may even have a less reactive renin-angiotensin system...
...Diuretics, which cause the body to excrete water and lower the load in the vessels, are the workhorse drugs with the longest history and the most direct effect. Diuretics work best in older patients, since younger metabolisms sense the change in fluid volume and react by activating the renin-angiotensin system to constrict vessels and boost pressure, negating the effects of the drugs...
...other categories of medications include beta-blockers, which moderate heart rate and the angiotensin system; calcium-channel blockers, which obstruct the tiny ducts in cells through which calcium ions must pass to constrict blood vessels; ACE inhibitors, which reduce the production of angiotensin and thus reduce constriction; and angiotensin-receptor blockers, which allow the protein to be produced but prevent some of it from being taken up by the cells. All four of these have the same goal--to unclench the tensed circulatory system--and they are often prescribed in combination...