title: Potential side effects of renin inhibitors--mechanisms based on comparison with other renin-angiotensin blockers.
abstract: Angiotensin (Ang) II plays important roles in the development of hypertension and cardiovascular and renal injury. Pharmaceutical approaches to block its activity led to the development of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. Numerous trials have documented their efficacy in controlling blood pressure, minimising left ventricular remodelling, preventing progression to heart failure, ameliorating proteinuria and retarding renal disease progression. Although they are considered safe in general, there remain concerns about the potential for adverse events in certain target populations. Recently, several novel, low molecular weight renin inhibitors without the extended peptide-like backbone of previous renin inhibitors were developed with favourable pharmacokinetic properties. They have been shown to successfully reduce Ang II levels in normal volunteers and to lower blood pressure in patients with mild-to-moderate hypertension. In this review, the authors summarise current knowledge about these renin inhibitors.
authors.affiliation: George M. O'Brien Kidney and Urologic Diseases Center and Division of Nephrology, Vanderbilt University School of Medicineand Nashville Veterans Affairs Hospital, Nashville, TN 37232, USA. huifang.cheng@vanderbilt.edu
authors.forename: Huifang
authors.initials: H
authors.lastname: Cheng
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Harris
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000209:etiology; D000577:Amides; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000818:Animals; D002986:Clinical Trials as Topic; D005650:Fumarates / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced*; D006973:Hypertension / Q000188:drug therapy*; D007022:Hypotension / Q000139:chemically induced*; D007177:Inappropriate ADH Syndrome / Q000139:chemically induced; D008297:Male; D051379:Mice; D012083:Renin / Q000502:physiology; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D005650:Fumarates; D012083:Renin; D000092502:Renin Inhibitors; C446481:aliskiren