Plasma renin and the antihypertensive effect of the orally active renin inhibitor aliskiren in clinical hypertension
Details
Serval ID
serval:BIB_A0783455FEA5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Plasma renin and the antihypertensive effect of the orally active renin inhibitor aliskiren in clinical hypertension
Journal
International Journal of Clinical Practice
ISSN
1368-5031 (Print)
Publication state
Published
Issued date
09/2007
Volume
61
Number
9
Pages
1461-8
Notes
Clinical Trial, Phase II
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Sep
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't --- Old month value: Sep
Abstract
BACKGROUND: Aliskiren is the first in a new class of orally effective renin inhibitors for the treatment of hypertension. METHODS: In 569 patients with mild-to-moderate hypertension, blood pressure (BP), plasma renin activity (PRA) and plasma renin concentration (PRC) were measured before and after 8 weeks of double-blind treatment with once-daily oral doses of aliskiren (150, 300 or 600 mg), irbesartan 150 mg or placebo. RESULTS: Aliskiren 150, 300 and 600 mg and irbesartan 150 mg significantly reduced mean cuff sitting systolic BP (SBP) from baseline (p < 0.001 vs. placebo). Aliskiren 150, 300 and 600 mg significantly reduced geometric mean PRA by 69%, 71% and 75% from baseline respectively (p < 0.05 vs. placebo). Irbesartan 150 mg significantly increased PRA by 109% (p < 0.05 vs. placebo). Aliskiren dose-dependently increased PRC from baseline by 157%, 246% and 497%, at 150, 300 and 600 mg respectively, compared with a 9% decrease with placebo (p < 0.05). PRC increased significantly more with aliskiren 300 and 600 mg compared with irbesartan 150 mg (105%; p < 0.05). Regression analysis showed no significant correlations between baseline PRA and changes in SBP in any of the treatment groups, but interestingly, the slopes of the regression lines between changes in SBP and log-transformed baseline PRA were +2.0 for placebo and -1.5, -1.8 and -2.3 for aliskiren 150, 300 and 600 mg respectively. The slope for irbesartan 150 mg (-1.4) was similar to that for aliskiren 150 mg. CONCLUSIONS: Aliskiren reduces SBP and PRA and increases PRC dose-dependently. In contrast, irbesartan reduces SBP but increases both PRC and PRA. As PRA is a measurement of angiotensin I-generating capacity, PRA can be used for measuring the ability of an antihypertensive agent to prevent the generation or action of Ang II, either directly (renin inhibitors, beta-blockers, central alpha(2)-agonists) or indirectly (AT(1)-receptor blockers, ACE inhibitors).
Keywords
Administration, Oral
Adult
Amides/*administration & dosage/adverse effects
Antihypertensive Agents/*administration & dosage/adverse effects
Dose-Response Relationship, Drug
Double-Blind Method
Female
Fumarates/*administration & dosage/adverse effects
Humans
Hypertension/*drug therapy
Male
Middle Aged
Renin/antagonists & inhibitors/*blood
Pubmed
Web of science
Create date
05/03/2008 16:41
Last modification date
20/08/2019 15:06