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 ) .
Aliskiren, a Novel Orally Effective Renin Inhibitor, Provides Dose-Dependent Antihypertensive Efficacy and Placebo-Like Tolerability in Hypertensive Patients
Background —Stopping the detrimental effects of the renin-angiotensin system at the most upstream point of the cascade offers theoretical advantages for cardiovascular protection . This study compares the antihypertensive efficacy and safety of the novel oral renin inhibitor aliskiren with placebo and an active comparator . Methods and Results —The study was a r and omized , multicenter , double-blind , placebo-controlled , active-comparator 8-week trial in patients with mild-to-moderate hypertension ( mean sitting diastolic blood pressure [ DBP ] ≥95 and < 110 mm Hg ) . After a 2-week , single-blind placebo run-in , 652 patients were r and omized to receive double-blind treatment with once-daily oral doses of aliskiren ( 150 , 300 , or 600 mg ) , irbesartan 150 mg , or placebo . Aliskiren 150 , 300 , and 600 mg effectively lowered both trough mean sitting DBP and systolic blood pressure ( SBP ) ( P<0.001 versus placebo for both variables ) . The least-squares mean reductions in trough DBP were 9.3±0.8 , 11.8±0.8 , and 11.5±0.8 mm Hg , respectively , versus 6.3±0.8 mm Hg for placebo , and the least-squares mean reductions in trough SBP were 11.4±1.3 , 15.8±1.2 , and 15.7±1.2 mm Hg , respectively , versus 5.3±1.2 mm Hg for placebo . The antihypertensive effect of aliskiren 150 mg was comparable to that of irbesartan 150 mg ( 8.9±0.7 and 12.5±1.2 mm Hg , least-squares reduction in mean sitting DBP and SBP , respectively , for irbesartan ) . Aliskiren 300 and 600 mg lowered mean sitting DBP significantly more than irbesartan 150 mg ( P<0.05 ) . Aliskiren  showed safety and tolerability comparable to those of placebo and irbesartan ; the incidence of adverse events and number of patients discontinuing therapy were similar in all groups . Conclusions —Once-daily oral treatment with aliskiren  lowers blood pressure effectively , with a safety and tolerability profile comparable to that of irbesartan and placebo , in patients with mild-to-moderate hypertension . Aliskiren 150 mg is as effective as irbesartan 150 mg in lowering blood pressure
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 ) .