The role of aliskiren in the management of hypertension and major cardiovascular outcomes: a systematic review and meta-analysis

“…Renin vaccines are the first vaccines developed. However, this vaccine has the risk of causing autoimmune diseases (61,62), and in clinical studies, renin inhibitors do not provide long-term cardiovascular and renal protective effects despite their ability to lower BP (63,64). Therefore, the future of renin vaccine to be used in clinic is not optimistic.…”

Section: Renin-angiotensin-aldosterone Systemmentioning

confidence: 99%

Advances in pathogenesis and treatment of essential hypertension

Chen

2022

Front. Cardiovasc. Med.

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Hypertension is a significant risk factor for cardiovascular and cerebrovascular diseases and the leading cause of premature death worldwide. However, the pathogenesis of the hypertension, especially essential hypertension, is complex and requires in-depth studies. Recently, new findings about essential hypertension have emerged, and these may provide important theoretical bases and therapeutic tools to break through the existing bottleneck of essential hypertension. In this review, we demonstrated important advances in the different pathogenesis areas of essential hypertension, and highlighted new treatments proposed in these areas, hoping to provide insight for the prevention and treatment of the essential hypertension.

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“…Because RAS is activated in obesity [15] and diabetes mellitus [16], aliskiren may have a better effect in patients with these conditions. However, since the failure of the aliskiren trial in type 2 diabetes using cardio-renal end-points (ALTITUDE) study [17], which showed no beneficial effect of aliskiren on cardiovascular and renal outcomes when added to ACE inhibitors or ARBs in diabetic and hypertensive patients, the role of aliskiren monotherapy has not been well investigated [18]. Herein, we conducted a prospec-tive randomized trial to compare the effects of renin inhibitors and calcium channel blockers on visceral fat and renal function in hypertensive patients with obesity or diabetes.…”

Section: Introductionmentioning

confidence: 99%

Effects of Aliskiren Monotherapy versus Amlodipine Monotherapy in Hypertensive Patients with Obesity or Type 2 Diabetes Mellitus

Seki,

Morimoto,

Kimura

et al. 2023

Kidney Blood Press Res

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Introduction: Renin-angiotensin system inhibitors have been reported to exert protective effects against organ damage and failure; however, the impact of direct renin inhibitor as monotherapy has not been assessed. Here we investigated the effects of 24-week monotherapy with aliskiren compared to amlodipine in hypertensive patients with type 2 diabetes or obesity. Methods: In this randomized intervention study, 62 adult hypertensive patients with visceral obesity (defined as a body mass index [BMI] greater than 25 kg/m2 and visceral adipose tissue area [VFA] greater than 100 cm2) or type 2 diabetes mellitus (age 57 ± 13, 65% men, BMI 28.8 ± 4.8 kg/m2, VFA 134.8 ± 47.0 cm2, blood pressure 141 ± 16/86 ± 13 mmHg) were randomized to receive 24-week treatment with aliskiren (max. 300 mg) or amlodipine (max. 10 mg). The primary outcome was the change in VFA at 24 weeks post-treatment. Results: Change in VFA did not differ significantly from baseline in either group. Systolic blood pressure significantly decreased at 12 weeks (-10 mmHg, P = 0.001) and 24 weeks (-10 mmHg, P = 0.001) in the amlodipine group and at 24 weeks (-11 mmHg, P = 0.001) in the aliskiren group. Diastolic blood pressure significantly decreased at 24 weeks (-6 mmHg, P = 0.009) only in the amlodipine group. Although the estimated glomerular filtration rates did not significantly change in either group, the logarithm of urinary albumin excretion significantly decreased at 24 weeks only in the aliskiren group (-0.60, P < 0.001). The 24-week changes in the urinary albumin excretion significantly correlated with the changes in the plasma renin activity in the aliskiren group (r = 0.51, P = 0.008). Conclusion: Aliskiren monotherapy did not show any superiority to amlodipine monotherapy on VFA, estimated glomerular filtration rates, or urinary albumin excretion in obese or type 2 diabetic hypertensive patients.

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The role of aliskiren in the management of hypertension and major cardiovascular outcomes: a systematic review and meta-analysis

Cited by 4 publications

References 62 publications

Diretrizes Brasileiras de Hipertensão Arterial – 2020

Diretrizes Brasileiras de Hipertensão Arterial – 2020

Advances in pathogenesis and treatment of essential hypertension

Effects of Aliskiren Monotherapy versus Amlodipine Monotherapy in Hypertensive Patients with Obesity or Type 2 Diabetes Mellitus

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