Angiotensin, fibrinolysis, and vascular homeostasis

There is strong evidence that imbalance of the fibrinolytic system is invol ved in the pathogenesis of ischemic cardiovascular events. A reduction in f ibrinolytic function may also mediate part of the adverse response of the v asculature to conditions of low nitric oxide production, Because reduced ni tric oxide activity predisposes to the development of atherosclerosis, imba lance of the fibrinolytic system is heavily implicated in the development o f cardiovascular pathology. The renin-angiotensin system exerts substantial control over the fibrinolytic system, and pharmacologic interventions that reduce the activity of angiotensin II also have favorable effects on fibri nolytic balance and on the incidence of adverse cardiovascular events. This review summarizes the evidence for a link between activation of the renin- angiotensin system, fibrinolytic imbalance, and cardiovascular pathology. ( C) 2001 by Excerpta Medica, Inc.