Journal de l'hypertension : accès libre

Renin-Angiotensin-Aldosterone System Pathways in Hypertension and Obese Adolescents

Abstract

Aadya Shrokowa*

The Renin-Angiotensin-Aldosterone System (RAAS) plays a pivotal role in regulating blood pressure and fluid balance, with both classical and alternative pathways contributing to its physiological effects. This review examines the involvement of RAAS pathways in the pathogenesis of hypertension and obesity in adolescents. Classical RAAS activation involves the conversion of angiotensinogen to Angiotensin II (Ang II), leading to vasoconstriction and aldosterone release, while alternative pathways, such as the Angiotensin-Converting Enzyme 2 (ACE2)/angiotensin-(1-7)/ Mas receptor axis, counterbalance these effects by promoting vasodilation and natriuresis. In obese adolescents, dysregulation of RAAS pathways contributes to hypertension through mechanisms including adipocyte-derived angiotensinogen, insulin resistance and sympathetic nervous system activation. Understanding the interplay between classical and alternative RAAS pathways is crucial for developing targeted interventions to manage hypertension and obesity-related complications in adolescents.