Renin inhibition

Azizi, Michel

doi:10.1097/01.mnh.0000242176.36953.f7

Cited by 24 publications

(18 citation statements)

References 68 publications

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“…AngI is cleved to AngII by the proteolytic activity of ACE, a pulmonary carboxyl dipeptidase. This conversion can occur through non-ACE pathways too (9). AngII provides main effects of RAS.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Serum Levels of Renin Angiotensin System Components in Asthmatic Patients

Ayada¹,

Toru²,

Genç³

et al. 2015

Erciyes Med J

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Objective: Asthma is a chronic inflammatory lung disease. The renin-angiotensin system (RAS) targets several tissues and maintains fluid homeostasis. It is also known that RAS plays a role in inflammatory processes. Angiotensin-converting enzyme (ACE) and its product angiotensin II (AngII), which are the components of RAS, regulate the known effects of RAS. The other components of RAS, ACE2 and its product Ang 1-7, regulate the counter-effects of RAS. That is why the activation or inhibition of RAS can offer new therapeutic strategies for treating several diseases. We aimed to investigate the serum level of RAS components such as angiotensinogen (AGT), ACE, AngII, ACE2, and Ang 1-7 in asthma and control groups. Materials and Methods:This study was performed on 27 asthma and 23 healthy individuals. The serum levels of AGT, ACE, AngII, ACE2, and Ang 1-7 were measured by human enzyme-linked immunosorbent assay (ELISA) kits.Results: There were no statistically significant differences for the serum levels of AGT and ACE between the groups. The serum levels of AngII, ACE2, and Ang 1-7 were significanlty higher in the asthma group than those in the control group. Conclusion:Our results indicate that two tails of RAS, i.e., the ACE and ACE2 pathways, are activated in asthma compared to are activated more in the asthma group than in the control group. We suppose that the activation of ACE2 tail of RAS occurs because of the homeostatic balance requirements of this system. We believe that the activation of ACE2 pathway, in addition to the inhibition of the ACE pathway, can provide clinical benefits in treating asthma.

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Section: Introductionmentioning

confidence: 99%

“…The physiological functions of AngII take place by its two specific receptors, AngII receptor subtype 1 (AT1R) and subtype 2 (AT2R). These receptors reveal the opposite effects of AngII (9). Most known effects of RAS occur via AT1R such as vascular hypertrophy, vasoconstriction, and hypertension (11).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Serum Levels of Renin Angiotensin System Components in Asthmatic Patients

Ayada¹,

Toru²,

Genç³

et al. 2015

Erciyes Med J

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“…15 However, the full clinical implications of the different effects of antihypertensive agents on PRA are not yet known. 16 We have previously reported the results of a randomised, double-blind study comparing the efficacy, safety and tolerability of aliskiren-and ramipril-based regimens during a 26-week activecontrolled-treatment period and a 4-week, randomised, placebo-controlled post-activecontrolled-treatment period in patients with mildto-moderate hypertension. 17 Here we present the effects of aliskiren-and ramipril-based treatment on PRA, PRC and other biomarkers.…”

Section: Introductionmentioning

confidence: 99%

Comparative effects of aliskiren-based and ramipril-based therapy on the renin system during long-term (6 months) treatment and withdrawal in patients with hypertension

Andersen

Weinberger

Constance

et al. 2009

J Renin Angiotensin Aldosterone Syst

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Introduction. This subgroup analysis assessed the effects of treatment based on the direct renin inhibitor, aliskiren, or the angiotensin-converting enzyme inhibitor, ramipril, on plasma renin activity (PRA), plasma renin concentration (PRC) and other biomarkers in a 26-week randomised, double-blind trial. Changes in PRA and PRC after stopping treatment were also assessed. Methods. After placebo run-in, 842 patients (mean sitting diastolic blood pressure (BP) 95—109 mmHg) were randomised to aliskiren 150 mg or ramipril 5 mg. Dose titration and hydrochlorothiazide addition were allowed after Week 6 and 12, respectively, for inadequate BP control. Patients completing active treatment were re-randomised to current regimen or placebo during a 4-week posttreatment phase. Results. BP reductions were independent of baseline PRA at Week 12, were greater with aliskiren- than ramipril-based therapy at Week 26 (17.9/13.3 vs. 15.2/12.0 mmHg, p<0.05) and persisted for longer after stopping aliskiren. Aliskiren-based therapy reduced geometric mean PRA (−63%, p<0.05; n=103), while ramipril-based therapy increased PRA (+143%, p<0.05; n=100) at Week 26; PRC increased in both groups (aliskiren: +224% [n=33], ramipril: +145% [n=39], both p<0.05). Four weeks after stopping aliskiren-based therapy, PRA remained 52% below pre-treatment baseline; PRA returned to baseline 2 weeks after stopping ramipril-based therapy. Conclusions. Aliskiren-based therapy produced sustained BP and PRA reductions over 26 weeks; ramipril-based therapy lowered BP and increased PRA. PRA reductions persisted 4 weeks after stopping aliskiren, suggesting an inhibitory effect beyond the elimination half-life of the drug.

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“…IVGTT was then performed with a standardized bolus injection of 300 mg of glucose per kilogram of body weight (in a 50% solution given over one minute). Plasma glucose and insulin levels were drawn after two, three, four, five, six, eight, 10,12,14,16,19,22,25,30,40, 50, 60, 70, 80, 90, 100, 120, 140, 160, and 180 minutes. Plasma glucose levels (millimoles per liter) were measured by the glucose oxidase method using a Beckmann analyzer (Beckmann Instruments).…”

Section: Metabolic Investigationsmentioning

confidence: 99%

“…15 However, the full clinical implications of the different effects of antihypertensive agents on PRA are not yet known. 16 An association between hyperinsulinemia and LV hypertrophy (H) was previously described, 17 but little has been written about the association between changes in insulin sensitivity and changes in LVM with antihypertensive therapy. In this study, we hypothesized that the effects of antihypertensive therapy on glucose and insulin metabolism (GIM) are associated with their effects on LV mass (M) regression.…”

Section: Introductionmentioning

confidence: 99%

Effects of antihypertensive therapy on glucose, insulin metabolism, left ventricular diastolic dysfunction and renin system in overweight and obese hypertensives

Rosa

Musella

Ilardi

et al. 2013

J Renin Angiotensin Aldosterone Syst

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Background:We attempted to test the hypothesis that the direct renin inhibitor aliskiren can improve diastolic dysfunction, glucose, and insulin metabolism (GIM) in overweight and obese hypertensive patients. Methods and results: Seventy-eight hypertensive patients were divided into two groups: 38 treated with aliskiren for six months, and 40 treated without aliskiren but with only traditional anti-hypertensive therapy, as controls. Doppler mitral flow velocity patterns were assessed before and after aliskiren during a six-month period. GIM (three-hour intravenous glucose tolerance test) was measured after four to six weeks of washout and six months of treatment. The mitral E/A ratio increased from 0.65 ± 0.11 to 0.75 ± 0.19. None of the indexes changed in the control group. In the control group, GIM parameters, fasting glucose levels (5.3 ± 0.9 to 6.0 ± 1.5 mmol/l; p = 0.003), fasting insulin levels (121 ± 121 to 189 ± 228 pmol/l; p = 0.03), and most other relevant metabolic measures (p < 0.05 for all) significantly worsened. Aliskiren did not affect GIM. In the control group LVM/height was not affected (119 ± 12 to 120 ± 17 g/m; p = 0.8), whereas aliskiren significantly reduced LVM/height (120 ± 13 to 111 ± 19 g/m; p = 0.04). Conclusions: Optimal target BP was achieved in the group as a whole and in both obese patient groups, while benefits to cardiac structure were of a smaller magnitude. In high-risk, overweight/obese patients with hypertension, traditional therapy provides significantly greater BP-versus aliskiren-lowering throughout the 24-hour dosing interval. Therefore in obese, hypertensive individuals, adequate and similar blood pressure control was achieved with aliskiren; however, the aliskiren group and not the control group was associated with a more favorable GIM profile and led to a significant regression of LVM; overall aliskiren-based treatment offers sustained control of PRA.Cardiology Unit, University ''Federico II'' Italy

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Renin inhibition

Cited by 24 publications

References 68 publications

Evaluation of Serum Levels of Renin Angiotensin System Components in Asthmatic Patients

Evaluation of Serum Levels of Renin Angiotensin System Components in Asthmatic Patients

Comparative effects of aliskiren-based and ramipril-based therapy on the renin system during long-term (6 months) treatment and withdrawal in patients with hypertension

Effects of antihypertensive therapy on glucose, insulin metabolism, left ventricular diastolic dysfunction and renin system in overweight and obese hypertensives

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