A 50 year-old male patient presented to his physician with a resting blood pressure of 160/100....

A 50 year-old male patient presented to his physician with a resting blood pressure of 160/100. He had no other medical concerns. He was prescribed Losartan, 50mg per day. This medication is an angiotensin II receptor antagonist. Discuss how a drop in renal blood flow will result in the formation of angiotensin II, and why Losartan will prevent a blood pressure increase.

Expert Solution

Angiotensinll is an octapeptide ac as a vasoconstrictor. It is formed from angiotensin l within the RAS reaction catalyzed by an angiotensin converting enzyme.Angiotensin l is made from angiotensinogen which is made in liver. Renin is converted angiotensinogen ro angiotensin l. It has three important function are the following :

Autoregulation of GFR
Reduction of salt excretion through direct and indirect actions on renal tubular cells
Growth modulation of renal cells

Cardiologic dysfunction impaired forward flow lead to decreased in renal blood flow. It activated the renin angiotensin aldosteron system also known as RAAS. Renin is secreted by juxtaglomerular cells in response to decreased renal arterial pressure, increased renal sympathetic activation from beta1 adrenergic receptors or decreased sodium delivery to macula densa cells. Renin converted angiotensinogen to angiotensin l and then it converted to angiotensin ll. Angiotensin ll formed from angiotensin l by angiotensin converting enzyme, stimulate the adrenal cortex to synthesis and secret aldosterone which decrease the excretion of sodium and increase the excretion of potassium.

Losartan is a non peptide angiotensin ll receptor antagonist. It completely block the binding of angiotensin ll to angiotensin l receptor. So it promote vasodialation and decrease the effect of aldosteron.

Nightingale answered 2 years ago

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