Updates on the Treatment of Essential Hypertension: A Summary of AHRQ’s Comparative Effectiveness Review of Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Direct Renin Inhibitors

Powers, Benjamin; Greene, Laurence; Balfe, Lisa M.

doi:10.18553/jmcp.2011.17.s8.1

Cited by 15 publications

(12 citation statements)

References 86 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When compared aliskiren with some active comparators [15,19] (ACEIs, amlodipine, HCTZ or atenolol), the results showed no difference in adverse events or in withdrawals due to adverse events (see Table 3 The incidence of adverse events, serious adverse events and withdrawal due to adverse events).…”

Section: The Incidence Of Adverse Eventsmentioning

confidence: 99%

Clinical efficacy, safety and tolerability of Aliskiren Monotherapy (AM): an umbrella review of systematic reviews

Zhao

Shen

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

Background: Aliskiren is a newly developed drug. Its role in lowering BP has been recognized. However, the role of aliskiren in treating heart and renal diseases are still controversial. Objective: To evaluate the existing evidence about clinical efficacy, safety and tolerability of aliskiren monotherapy (AM). Methods: An umbrella review of systematic reviews of interventional studies. We searched Pubmed, Embase and Cochrane Library up to June 2019. Two reviewers applied inclusion criteria to the select potential articles independently. The extract and analyze of accessible data were did by two reviewers independently too. Discrepancies were resolved with discussion or the arbitration of the third author. Results: Eventually, our review identified 14 eligible studies. Results showed that for essential hypertension patients, aliskiren showed a great superiority over placebo in BP reduction, BP response rate and BP control rate. Aliskiren and placebo, ARBs or ACEIs showed no difference in the number or extent of adverse events. For heart failure patients, AM did not reduce BNP levels (SMD-0.08, − 0.31 to 0.15) or mortality rate (RR 0.76, 0.32 to 1.80), but it decreased NT-proBNP (SMD-0.12, − 0.21 to − 0.03) and PRA levels (SMD 0.52, 0.30 to 0.75), increased PRC levels (SMD-0.66, − 0.8 to − 0.44). For patients who are suffered from hypertension and diabetes and/or nephropathy or albuminuria at the same time, aliskiren produced no significant effects (RR 0.97, 0.81 to 1.16). Conclusion: We found solid evidence to support the benefits of aliskiren in the treatment of essential hypertension, aliskiren can produce significant effects in lowering BP and reliable safety. However, the effects of aliskiren in cardiovascular and renal outcomes were insignificant. Trial registration: Study has been registered in PROSPERO (CRD42019142141).

show abstract

Section: The Incidence Of Adverse Eventsmentioning

confidence: 99%

Clinical efficacy, safety and tolerability of Aliskiren Monotherapy (AM): an umbrella review of systematic reviews

Zhao

Shen

et al. 2020

BMC Cardiovasc Disord

View full text Add to dashboard Cite

show abstract

“…Nevertheless, important limitations have been reported related to the use of these RAS blockers. For instance, besides their potential side effects, the responses to ACEi treatment are influenced by gender and ethnic diversity and ARBs have limited efficacy in treatment of end‐organ damage (Powers et al ., ).…”

Section: Introductionmentioning

confidence: 99%

“…Within this view, angiotensinogen synthesized in the liver is converted into the inactive peptide angiotensin (Ang) I through the renin action, which is produced by the juxtaglomerular cells of the kidney (Hall et al, related to the use of these RAS blockers. For instance, besides their potential side effects, the responses to ACEi treatment are influenced by gender and ethnic diversity and ARBs have limited efficacy in treatment of end-organ damage (Powers et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

ACE2, angiotensin‐(1‐7) and Mas receptor axis in inflammation and fibrosis

Silva

Silveira

Ferreira

et al. 2013

British J Pharmacology

483

384

View full text Add to dashboard Cite

Recent advances have improved our understanding of the renin‐angiotensin system (RAS). These have included the recognition that angiotensin (Ang)‐(1‐7) is a biologically active product of the RAS cascade. The identification of the ACE homologue ACE2, which forms Ang‐(1‐7) from Ang II, and the GPCR Mas as an Ang‐(1‐7) receptor have provided the necessary biochemical and molecular background and tools to study the biological significance of Ang‐(1‐7). Most available evidence supports a counter‐regulatory role for Ang‐(1‐7) by opposing many actions of Ang II on AT1 receptors, especially vasoconstriction and proliferation. Many studies have now shown that Ang‐(1‐7) by acting via Mas receptor exerts inhibitory effects on inflammation and on vascular and cellular growth mechanisms. Ang‐(1‐7) has also been shown to reduce key signalling pathways and molecules thought to be relevant for fibrogenesis. Here, we review recent findings related to the function of the ACE2/Ang‐(1‐7)/Mas axis and focus on the role of this axis in modifying processes associated with acute and chronic inflammation, including leukocyte influx, fibrogenesis and proliferation of certain cell types. More attention will be given to the involvement of the ACE2/Ang‐(1‐7)/Mas axis in the context of renal disease because of the known relevance of the RAS for the function of this organ and for the regulation of kidney inflammation and fibrosis. Taken together, this knowledge may help in paving the way for the development of novel treatments for chronic inflammatory and renal diseases.

show abstract

“…It has been previously demonstrated that long-term cerebral arteriolar contraction causes the decrease in the number of open microvessels and diminishes the CBF in SHR [23, 24]. The clinical application of calcium channel blockers, diuretics, β -receptor blockers, angiotensin converting enzyme inhibitors, and AT1R antagonists can relieve vasospasm and reduce blood pressure [25]. However, these drugs have little effect on CBF.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Stimulation with Electroacupuncture at DU20 and ST36 Rescues Hippocampal Neuron through Attenuating Cerebral Blood Flow in Spontaneously Hypertensive Rats

Tian

Sun

Huang

et al. 2013

Evidence-Based Complementary and Alternative Medicine

View full text Add to dashboard Cite

This study was designed to investigate the effect of long-term electroacupuncture at Baihui (DU20) and Zusanli (ST36) on cerebral microvessels and neurons in CA1 region of hippocampus in spontaneously hypertensive rats (SHR). A total of 45 male Wistar rats and 45 SHR were randomly grouped, with or without electroacupuncture (EA) at DU20 and ST36, once every other day for a period of 8 weeks. The mean arterial pressure (MAP) was measured once every 2 weeks. Cerebral blood flow (CBF) and the number of open microvessels in hippocampal CA1 region were detected by Laser Doppler and immunohistochemistry, respectively. Nissl staining and Western blotting were performed, respectively, to determine hippocampus morphology and proteins that were implicated in the concerning signaling pathways. The results showed that the MAP in SHR increased linearly over the observation period and was significantly reduced following electroacupuncture as compared with sham control SHR rats, while no difference was observed in Wistar rats between EA and sham control. The CBF, learning and memory capacity, and capillary rarefaction of SHR were improved by EA. The upregulation of angiotensin II type I receptor (AT1R), endothelin receptor (ETAR), and endothelin-1 (ET-1) in SHR rats was attenuated by electroacupuncture, suggesting an implication of AT1R, ETAR, and ET-1 pathway in the effect of EA.

show abstract

Updates on the Treatment of Essential Hypertension: A Summary of AHRQ’s Comparative Effectiveness Review of Angiotensin-Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Direct Renin Inhibitors

Cited by 15 publications

References 86 publications

Clinical efficacy, safety and tolerability of Aliskiren Monotherapy (AM): an umbrella review of systematic reviews

Clinical efficacy, safety and tolerability of Aliskiren Monotherapy (AM): an umbrella review of systematic reviews

ACE2, angiotensin‐(1‐7) and Mas receptor axis in inflammation and fibrosis

Long-Term Stimulation with Electroacupuncture at DU20 and ST36 Rescues Hippocampal Neuron through Attenuating Cerebral Blood Flow in Spontaneously Hypertensive Rats

Contact Info

Product

Resources

About