Renin inhibition: a new modality for hypertension management.
Renin is the first and rate-limiting step cleaving angiotensinogen to angiotensin I, thus influencing angiotensin II (Ang II) formation. Inhibition of the renin-angiotensin system (RAS) with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) is effective in management of several cardiovascular diseases; however, control continues to be difficult and requires multiple drug therapy. Use of RAS inhibitors does not totally prevent Ang II formation, which could continue to contribute to development of end-organ damage. Over the past two decades, renin inhibition seemed to be an attractive approach for complete blockade of the RAS. Recently, aliskiren, a renin inhibitor, was approved as the first of a new class of antihypertension drugs. Clinical trials demonstrated significant blood pressure reduction in hypertensive patients with aliskiren used alone or combined with hydrochlorothiazide, ACE inhibitors, or ARBs. Studies are in progress to evaluate the potential role for renin inhibition in management of kidney and cardiac diseases.
Division of Endocrinology and Metabolism, Department of Medicine, PO Box 801409, University of Virginia Health System, Charlottesville, VA 22908-1409, USA. hms7a@virginia.edu
Helmy M
HM
Siragy
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects; D000092502:Renin Inhibitors
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D000092502:Renin Inhibitors