There was a dose-dependent decrease in blood pressure for aliskiren 75 mg , 150 mg and 300 mg .
Aliskiren had no effect on blood pressure variability .
Due to very limited information available regarding change in heart rate and pulse pressure , it was not possible to meta-analyze these outcomes .Mortality and non-fatal serious adverse events were not increased .
AUTHORS ' CONCLUSIONS Compared to placebo , aliskiren lowered BP and this effect is dose-dependent .
This magnitude of BP lowering effect is similar to that for angiotensin-converting enzyme ( ACE ) inhibitors and angiotensin receptor blockers ( ARBs ) .
There is no difference in mortality , nonfatal serious adverse events or withdrawal due to adverse effects with short term aliskiren monotherapy .
BACKGROUND Hypertension is a chronic condition associated with an increased risk of mortality and morbidity .
Renin is the enzyme responsible for converting angiotensinogen to angiotensin I , which is then converted to angiotensin II .
Renin inhibitors are a new class of drugs that decrease blood pressure ( BP ) by preventing the formation of both angiotensin I and angiotensin II .
OBJECTIVES To quantify the dose-related BP lowering efficacy of renin inhibitors compared to placebo in the treatment of primary hypertension .
To determine the change in BP variability , pulse pressure , and heart rate and to evaluate adverse events ( mortality , non-fatal serious adverse events , total adverse events , withdrawal due to adverse effects and specific adverse events such as dry cough , diarrhoea and angioedema ) .
Comparative efficacy and safety of aliskiren, an oral direct renin inhibitor, and ramipril in hypertension: a 6-month, randomized, double-blind trial
Objectives This double-blind study compared long-term efficacy , safety and tolerability of the oral direct renin inhibitor aliskiren and the angiotensin-converting enzyme inhibitor ramipril alone and combined with hydrochlorothiazide in patients with hypertension . Methods After a 2–4-week placebo run-in , 842 patients [ mean sitting diastolic blood pressure ( msDBP ) 95–109 mmHg ] were r and omized to aliskiren 150 mg ( n = 420 ) or ramipril 5 mg ( n = 422 ) . Dose titration ( to aliskiren 300 mg/ramipril 10 mg ) and subsequent hydrochlorothiazide addition ( 12.5 mg , titrated to 25 mg if required ) were permitted at weeks 6 , 12 , 18 and 21 for inadequate blood pressure control . Patients completing the 26-week active-controlled treatment period were re-r and omized to their existing regimen or placebo for a 4-week double-blind withdrawal phase . Results Six hundred and eighty-seven patients ( 81.6 % ) completed the active treatment period . At week 26 , aliskiren-based therapy produced greater mean reductions in mean sitting systolic blood pressure ( 17.9 versus 15.2 mmHg , P = 0.0036 ) and msDBP ( 13.2 versus 12.0 mmHg , P = 0.025 ) , and higher rates of systolic blood pressure control ( < 140 mmHg ; 72.5 versus 64.1 % , P = 0.0075 ) compared with ramipril-based therapy . During withdrawal , blood pressure increased more rapidly after stopping ramipril than aliskiren-based therapy  ; median blood pressure reached 140/90 mmHg after 1 and 4 weeks , respectively . Blood pressure reductions were maintained with continued active treatment . Aliskiren therapy was well tolerated . Overall adverse event rates were similar with aliskiren ( 61.3 % ) and ramipril ( 60.4 % ) ; cough was more frequent with ramipril ( 9.5 % ) than aliskiren ( 4.1 % ) . Conclusions Aliskiren-based therapy was well tolerated and produced sustained blood pressure reductions in patients with hypertension over 6 months , greater than those with ramipril-based therapy
There was a dose-dependent decrease in blood pressure for aliskiren 75 mg , 150 mg and 300 mg .
Aliskiren had no effect on blood pressure variability .
Due to very limited information available regarding change in heart rate and pulse pressure , it was not possible to meta-analyze these outcomes .Mortality and non-fatal serious adverse events were not increased .
AUTHORS ' CONCLUSIONS Compared to placebo , aliskiren lowered BP and this effect is dose-dependent .
This magnitude of BP lowering effect is similar to that for angiotensin-converting enzyme ( ACE ) inhibitors and angiotensin receptor blockers ( ARBs ) .
There is no difference in mortality , nonfatal serious adverse events or withdrawal due to adverse effects with short term aliskiren monotherapy .
BACKGROUND Hypertension is a chronic condition associated with an increased risk of mortality and morbidity .
Renin is the enzyme responsible for converting angiotensinogen to angiotensin I , which is then converted to angiotensin II .
Renin inhibitors are a new class of drugs that decrease blood pressure ( BP ) by preventing the formation of both angiotensin I and angiotensin II .
OBJECTIVES To quantify the dose-related BP lowering efficacy of renin inhibitors compared to placebo in the treatment of primary hypertension .
To determine the change in BP variability , pulse pressure , and heart rate and to evaluate adverse events ( mortality , non-fatal serious adverse events , total adverse events , withdrawal due to adverse effects and specific adverse events such as dry cough , diarrhoea and angioedema ) .