Table 5 THE RAAS ACRONYM: GLOBAL RISK REDUCTION

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 inhibitors – Angiotensin 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 HbA_1c 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