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 ) .
Effect of aliskiren on vascular remodelling in small retinal circulation
Background : In hypertension , changes in small arterial structure are characterized by an increased wall-to-lumen ratio ( WLR ) . These adaptive processes are modulated by the rennin – angiotensin system . It is unclear whether direct renin inhibitors exert protective effects on small arteries in hypertensive patients . Methods : In this double-blind , r and omized , placebo-controlled study ( www . clinical trials.gov : NCT01318395 ) , 114 patients with primary hypertension were r and omized to additional therapy with either placebo or aliskiren 300 mg for 8 weeks after 4 weeks of st and ardized open-label treatment with valsartan 320 mg ( run-in phase ) . Parameter of arteriolar remodelling was WLR of retinal arterioles ( 80 – 140 & mgr;m ) assessed noninvasively and in vivo by scanning laser Doppler flowmetry ( Heidelberg Engineering , Germany ) . In addition , pulse wave analysis ( SphygmoCor , AtCor Medical , Australia ) and pulse pressure ( PP ) amplification were determined . Results : In the whole study population , no clear effect of additional therapy with aliskiren on vascular parameters was documented . When analyses were restricted to patients with vascular remodelling , defined by a median of WLR more than 0.3326 ( n = 57 ) , WLR was reduced after 8 weeks by the treatment with aliskiren compared with placebo ( –0.044 ± 0.07 versus 0.0043 ± 0.07 , P = 0.015 ) . Consistently , after 8 weeks of on-top treatment with aliskiren , there was an improvement of PP amplification compared with placebo ( 0.025 ± 0.07 versus -0.034 ± 0.08 , P = 0.013 ) , indicative of less stiff arteries in the peripheral circulation . Conclusion : Thus , our data indicate that treatment with aliskiren , given on top of valsartan therapy , improves altered vascular remodelling in hypertensive patients
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 ) .