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 ) .
Safety and efficacy of the oral direct renin inhibitor aliskiren in elderly patients with hypertension
Objectives . To evaluate the efficacy , safety and tolerability of aliskiren in elderly patients ( ⩾65 years old ) with essential hypertension . Methods . In this double‐blind , multicenter study , 355 elderly patients with hypertension [ office mean sitting systolic blood pressure ( msSBP ) ⩾145–<180 mmHg and mean 24‐h ambulatory systolic BP ( ASBP ) ⩾135 mmHg ] were r and omized to once‐daily treatment for 8 weeks with aliskiren 75 mg ( n = 91 ) , 150 mg ( n = 84 ) , 300 mg ( n = 94 ) or the comparator lisinopril 10 mg ( n = 86 ) . The primary efficacy variable was change in mean 24‐h ASBP . Results . At endpoint , aliskiren 75 mg , 150 mg , 300 mg and lisinopril 10 mg lowered mean 24‐h ASBP ( least‐squares mean±SEM ) by 8.4±0.8 , 7.1±0.8 , 8.7±0.8 and 10.2±0.9 mmHg , and mean 24‐h ambulatory diastolic BP by 4.5±0.5 , 3.6±0.5 , 3.9±0.5 and 6.3±0.5 mmHg , respectively , with no significant difference between aliskiren doses . The trough‐to‐peak ratio for ASBP reduction with aliskiren 75 mg , 150 mg , 300 mg and lisinopril 10 mg was 0.77 , 0.64 , 0.79 and 0.87 , respectively . All treatments lowered office msSBP and mean sitting diastolic BP ( msDBP ) compared with baseline . A significantly greater proportion of patients receiving aliskiren 300 mg achieved BP control ( msSBP/msDBP < 140/90 mmHg ) compared with those receiving aliskiren 75 mg ( 36.2 % vs 24.2 % , p = 0.033 ) . There was no evidence of dose‐related increases in the rate of adverse events with aliskiren treatment . Conclusions . Aliskiren , a novel direct renin inhibitor , provides effective 24‐h BP lowering with no evidence of dose‐related increases in the incidence of adverse events in elderly patients with hypertension . Trial registration : Clinical Trials.gov identifier : NCT00219167
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 ) .