Interfering of antihypertensive effect of Aliskiren and Nebivolol combination with Renin-Angiotensin and sympatic systems suppression

Abstract

The objective of the study was to compare efficacy of aliskiren alone, nebivolol alone, and aliskiren and nebivolol in combination in essential hypertension patients. Methods: The study evolved 123 patients (68 males) aged 48 to 62 years with moderate-to-severe arterial hypertension. Aliskirten alone was prescribed for 41 subjects in daily doses 150-300 mg orally (1str group). Nebivolol was given for 50 Olga S. Nalotova 2 nd group patients in 5-10 mg daily orally, and combined therapy with both drug (aliskiren 150 mg daily and nebivolol 5 mg daily orally) was prescribed for 43 subjects (3 rd group). Office blood pressure, heart rate was measured at baseline and in1 weeks during 8 weeks of observation period. Blood sampling for further biochemical and biomarkers measurements was obtained at baseline and in 8 weeks. Twenty hours urine norepinephrine excretion was examined by column chromatography methods. Renin activity in plasma and concentration of aldosteron were measured by IFA method. Results: All patients have achieved a target level of blood pressure for 8 weeks of observation period. The most effective of pharmacotherapy strategy was a combination of aliskiren and nebivolol that leads reduced systolic and diastolic office blood pressure up 18.8 ± 1.2% and 18.6 ± 0.9%. However, all patients that were treated with drug combination have achieved target level of BP (less 140 / 90 mm Hg) in 2 weeks after baseline. During 8 weeks treatment period SAS and RAS activity was decreased closely in all patient groups. However, combination aliskiren and nebivolol let to overcome hyperactivation of both SAS and RAS In conclusion, combination aliskiren with nebivolol is effective in treating patients with hypertension. The significantly decreased effect on blood pressure found in patients may be attributed to decreased neurohumoral activity of the RAS and SAS

The fixed combination of aliskiren and nebivolol in hypertensive patients: the clinical perspectives

“…However, the data regarding co-administration of both drugs are very limited. Recent pre-clinical studies have been shown that concomitant administration of aliskiren and nebivolol given in fixed combination did not form any active chemical complexes with novel pharmacological abilities [14][15][16][17]. With the semiempirical quantum-chemical method РМ7, which was optimized for calculations of organic molecules and their complexes and then implemented using the МОРАС-2012 program, we previously assayed energy of intra-and intermolecular interactions between both molecules aliskiren and nebivolol given in fixed combination.…”