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Table 5 THE RAAS ACRONYM: GLOBAL RISK REDUCTION

From: Vasa vasorum in plaque angiogenesis, metabolic syndrome, type 2 diabetes mellitus, and atheroscleropathy: a malignant transformation

R Reductase inhibitors (HMG-CoA). Decreasing modified LDL-cholesterol, i.e. oxidized, acetylated LDL-cholesterol. Decreasing triglycerides and increasing HDL-cholesterol Improving endothelial cell dysfunction. Restoring the abnormal Lipoprotein fractions. Thus, decreasing the redox and oxidative stress to the arterial vessel wall and myocardium.
  Redox stress reduction.
A AngII inhibition or blockade: ACE inhibitorsAngiotensin II receptor blockers: Both inhibiting the effect of angiotensin-II locally as well as systemically. Affecting hemodynamic stress through their antihypertensive effect as well as the deleterious effects of angiotensin II on cells at the local level – injurious stimuli-decreasing the stimulus for O 2 production. Decreasing the A-FLIGHT toxicities. Plus the direct-indirect antioxidant effect within the arterial vessel wall and capillary. Antioxidant effects. Aspirin antiplatelet, anti-inflammatory effect. Adrenergic (non-selective blockade) in addition to its blockade of Prorenin → Renin Amlodipine with its calcium channel blocking antihypertensive effect, in addition to its direct antioxidant effects.
  Redox stress reduction.
A Aggressive control of diabetes to HbA1c of less than 7. (This usually requires combination therapy with the use of: Insulin secretagogues, insulin sensitizers (thiazolidinediones), biguanides, alpha-glucosidase inhibitors, and ultimately exogenous insulin.). Decreasing modified LDL cholesterol, i.e. glycated – glycoxidated LDL cholesterol. Improving endothelial cell dysfunction. Also decreasing glucotoxicity and the oxidative – redox stress to the intima and pancreatic islet. Aggressive control of blood pressure, which usually requires combination therapy, including thiazide diuretics to attain JNC 7 guidelines. Aggressive control of Hcy with folic acid and its associated pleiotropic positive effect on re-coupling the eNOS reaction by restoring the activity of the BH4 cofactor to run the eNOS reaction and once again produce eNO, as well as, its direct antioxidant effects: BH4 and eNOS stabilization
  Redox stress reduction.
S Statins. Improving plaque stability (pleiotropic effects) independent of cholesterol lowering. Improving endothelial cell dysfunction. Plus, the direct – indirect antioxidant anti-inflammatory effects [45] within the islet and the arterial vessel wall promoting stabilization of the unstable, vulnerable islet and the arterial vessel wall. Style: Lifestyle modification: lose weight, exercise, and change eating habits. S top S moking
  Redox stress reduction