Angiotensin II, Aldosterone, Fetal Development, Wound Healing, Pressure Maintenance and Heart Failure
Over several of the last posts, I have written about the critical role of aldosterone in cardiovascular diseases. Let’s provide most context to the story. In early healthy life angiotensin II (ang II) and aldosterone play a vital role in sustaining healthy life. Both molecules are products of renin-angiotensin system activation.
Healthy Life
Angiotensin II is part of the epigenetic process that forms a normal kidney in the developing fetus.
These molecules are vital to healing skin and vascular wounds.
They retain salt and water with excessive sweating or bleeding to maintain blood pressure, function, and life.
These are essential functions.
Congestive Heart Failure and Heart Attack
In many ways, a heart attack is a wound. A rupture of an inflamed cholesterol deposit leads to a clot that blocks the artery. The muscle downstream of the clot dies and stops pumping. The dead muscle softens and can result in heart rupture at that spot. Wound healing and scar formation are essential to prevent heart rupture. Angiotensin II and aldosterone production increase just after the heart attack occurs to support the healing process. Once the genes that produce ang II and aldosterone are switched on, they stay on. That leads to scar tissue formation, death of heart muscle pumping cells, and inflammation. Losartan or lisinopril and spironolactone or eplerenone very precisely interfere with this remodeling process. Without these disease modifying treatments, heart failure is relentlessly progressive and the heart becomes weaker and weaker causing death within a few years.
This is a great example of a fundamental principle in chronic disease generally. Most chronic illness is not caused by gene mutations or abnormal genes. It is caused by genes that are essential to development and normal health but are abnormally switched on later in life by things like increased abdominal fat and trauma. A process that is essential to normal fetal development make us sick later. Now we understand much more about these processes and we can interfere with them precisely. That is why certain medications are so critical in our protocols.