skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8852

Renoprotection, renin inhibition, and blood pressure control: the impact of aliskiren on integrated blood pressure control

Review

(1613) Views  (622) Full article downloads

Authors: Haroon-Ur Rashid

Published Date October 2010 Volume 2010:3 Pages 133 - 144
DOI: http://dx.doi.org/10.2147/IBPC.S12407

Haroon-Ur Rashid
Department of Cardiology, Baylor College of Medicine, Texas Heart Institute, Houston, TX, USA

Abstract: Hypertension (HTN) is an important factor in progressive loss of renal function. The kidney can be both a contributor to and a target of HTN. The functional integrity of the kidney is vital for the maintenance of cardiovascular homeostasis. Chronic activation of the renin system causes HTN and, ultimately, end-organ damage. Direct renin inhibitors (DRIs) inhibit plasma renin activity (PRA), thereby preventing the conversion of angiotensinogen to angiotensin I; consequently, the levels of both Ang I and Ang II are reduced. There is no compensatory increase in PRA activity with DRIs as seen with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). There are reasons to speculate that renin inhibition might prove to be a superior strategy for blocking the renin–angiotensin–aldosterone system compared with ACEIs or ARBs. Evidence for the efficacy of aliskiren (a DRI) is considered to be relatively strong, based on published, short-term, double-blind, randomized, controlled trials showing that aliskiren is as effective as other antihypertensive agents in reducing blood pressure (BP), with no rebound effects on BP after treatment withdrawal. When combined with diuretics, fully additive BP reduction is seen. When given with an ACEI or ARB, aliskiren produces significant additional BP reduction indicative of complimentary pharmacology and more complete renin–angiotensin system blockade.

Keywords: aliskiren, direct renin inhibitor, angiotensin-converting enzyme inhibitor, ACE inhibitor, angiotensin II receptor blocker, chronic kidney disease, hypertension, diabetes mellitus






Readers of this article also read:

Antihypertensive effects of astaxanthin
Impact of dyslipidemia on cardiovascular risk stratification of hypertensive patients and association of lipid profile with other cardiovascular risk factors: results from the ICEBERG study
Role of aliskiren in cardio-renal protection and use in hypertensives with multiple risk factors
Effects of antihypertensive drugs on carotid intima-media thickness: Focus on angiotensin II receptor blockers. A review of randomized, controlled trials
Fixed combinations in the pragmatic management of hypertension: focus on aliskiren and hydrochlorothiazide as a single pill
Role of aliskiren in blood pressure control and renoprotection
Perception of risk and benefit in patient-centered communication and care
The relationship between deliberate self-harm behavior, body dissatisfaction, and suicide in adolescents: current concepts
Zinc oxide nanoparticles as selective killers of proliferating cells
Cumulative clinical experience from over a decade of use of levofloxacin in community-acquired pneumonia: critical appraisal and role in therapy
  • Testimonials

    "... I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University