PTGS2 and cardiac hypertrophy: Moreover, Ang II induces ROS formation in VSMCs [27] that activate COX2 and TPR signaling in many models of CVD or CKD [25,26,28,29,30], while COX2 generation in mice increases Ang II-induced hypertension and causes oxidative stress, cardiac hypertrophy [31] and pressure-overload heart failure [32].