How many effects can dance on the head of a SNP?

摘要

Several dozen publications have identified relationships between cardiac phenotypes and genotypes of the renin-angiotensin-aldosterone system (RAAS). The study by Tsai et al in this issue of HeartRhythm now identifies that RAAS genotype predicts stroke and its response to therapy. The findings merit a review of our understanding of the RAAS system, its genetics, and cardiovascular genotype-phenotype associations. RAAS is a hormonal system that primarily regulates blood pressure and fluid volume. Kidney-produced renin converts liver-produced angiotensinogen into angiotensin I, which is then converted to angiotensin II by lung-produced angio-tensin-converting enzyme (ACE). Angiotensin II is a potent vasoconstrictor; it also stimulates secretion of adrenal-produced aldosterone, causing reabsorption of sodium and water by the kidney.