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 ) .
Renal Effects of Aliskiren Compared With and in Combination With Irbesartan in Patients With Type 2 Diabetes, Hypertension, and Albuminuria
OBJECTIVE We investigated whether the antiproteinuric effect of the direct renin inhibitor aliskiren is comparable to that of irbesartan and the effect of the combination . RESEARCH DESIGN AND METHODS This was a double-blind , r and omized , crossover trial . After a 1-month washout period , 26 patients with type 2 diabetes , hypertension , and albuminuria ( > 100 mg/day ) were r and omly assigned to four 2-month treatment periods in r and om order with placebo , 300 mg aliskiren once daily , 300 mg irbesartan once daily , or the combination using identical doses . Patients received furosemide in a stable dose throughout the study . The primary end point was a change in albuminuria . Secondary measures included change in 24-h blood pressure and glomerular filtration rate ( GFR ) . RESULTS Placebo geometric mean albuminuria was 258 mg/day ( range 84–2,361 ) , mean ± SD 24-h blood pressure was 140/73 ± 15/8 mmHg , and GFR was 89 ± 27 ml/min per 1.73 m2 . Aliskiren treatment reduced albuminuria by 48 % ( 95 % CI 27–62 ) compared with placebo ( P < 0.001 ) , not significantly different from the 58 % ( 42–79 ) reduction with irbesartan treatment ( P < 0.001 vs. placebo ) . Combination treatment reduced albuminuria by 71 % ( 59–79 ) , more than either monotherapy ( P < 0.001 and P = 0.028 ) . Fractional clearances of albumin were significantly reduced ( 46 , 56 , and 67 % reduction vs. placebo ) . Twenty-four-hour blood pressure was reduced 3/4 mmHg by aliskiren ( NS/P = 0.009 ) , 12/5 mmHg by irbesartan ( P < 0.001/P = 0.002 ) , and 10/6 mmHg by the combination ( P = 0.001/P < 0.001 ) . GFR was significantly reduced 4.6 ( 95 % CI 0.3–8.8 ) ml/min per 1.73 m2 by aliskiren , 8.0 ( 3.6–12.3 ) ml/min per 1.73 m2 by irbesartan , and 11.7 ( 7.4–15.9 ) ml/min per 1.73 m2 by the combination . CONCLUSIONS The combination of aliskiren and irbesartan is more antiproteinuric in type 2 diabetic patients with albuminuria than monotherapy
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 ) .