The Renin Angiotensin Aldosterone System in Hypertension: Roles of Insulin Resistance and Oxidative Stress

Hypertension (HTN) is a leading risk factor for cardiovascular disease (CVD) and chronic kidney disease (CKD)-related morbidity and mortality. Several abnormalities participate in the development of HTN. Inappropriately activated systemic and local tissue renin angiotensin aldosterone systems (RAAS) contribute to the hemodynamic and metabolic abnormalities that lead to endothelial dysfunction, HTN, CVD, and CKD. There is a growing body of evidence demonstrating a close relationship between RAAS activation, excessive production of reactive oxygen species, insulin resistance, and HTN. From a therapeutic standpoint, RAAS blockade results in improved insulin resistance, glucose homeostasis, and improved cardiovascular and renal outcomes. This article is focused on the role of RAAS-mediated insulin resistance and oxidative stress in the pathogenesis of HTN, CVD, and CKD.