Cardiovascular Peptides

Cardiovascular peptides encompass a broad group of endogenous signaling molecules and therapeutic agents that regulate vascular tone, cardiac output, fluid balance, and tissue remodeling in the heart and blood vessels. Many of the most important cardiovascular drug classes target peptide signaling pathways, including ACE inhibitors (which modulate angiotensin and bradykinin), endothelin receptor antagonists, and natriuretic peptide-based therapies.

This category includes both vasodilatory peptides such as angiotensin-(1-7), apelin-13, adrenomedullin, and nesiritide, as well as the potent vasoconstrictor endothelin-1, whose receptor antagonists (bosentan, ambrisentan, macitentan) are mainstays of pulmonary arterial hypertension therapy. Relaxin-2, although primarily a reproductive hormone, demonstrated significant cardiovascular effects in heart failure trials. Bradykinin, a key mediator of the kallikrein-kinin system, plays dual roles in cardioprotection and pathological edema.

The evidence base for cardiovascular peptides varies significantly. Nesiritide is FDA-approved for acute decompensated heart failure, while others like apelin-13 remain in preclinical investigation. Understanding these peptides is essential for appreciating both current cardiovascular therapeutics and emerging treatment strategies.