It has become clear that Angiotensin II and NO signaling pathways interact with each other in many ways . Angiotensin II acts at both AT1 and AT2 receptors to regulate NOS activity andNO production. NO, via its downstream effector cGMP (as well as by S-nitrosylation and other chemical effects), opposes Angiotensin II signaling pathways at multiple levels. In this way, the multiple functions of Angiotensin II and NO are precisely balanced. Many cardiovascular diseases are associated with an imbalance of Angiotensin II and NO actions. Cardiovascular risk factors appear to “tip” the balance in favor of Angiotensin II, at least in part by way of oxidative stress. However, other mechanisms may include inhibition of NO effectors, such as cGMP, by inhibiting its formation (effects on pGC and sGC) and enhancing its degradation (effects on
PDEs). Therapeutic strategies capable of restoring the balance
within the vessel wall should be effective in preventing cardiovascular
events.