Rational of the use of aliskiren in hypertension and beyond.
Arterial hypertension is an independent risk factor for cardiovascular diseases and one of the major causes for mortality worldwide. Drugs, that control hypertension effectively are therefore needed to reduce hypertension induced morbidity and mortality. The inhibition of the renin-angiotensin-aldosterone-system (RAAS) is one target to control blood pressure in these patients. The new direct renin inhibitor aliskiren is one new substance on the market to inhibit the RAAS effectively by suppression of the plasma renin activity, which inhibits the RAAS at its rate-limiting step. Therefore, aliskiren in monotherapy and in combination might yield beneficial effects for the patients. Nevertheless, blood pressure lowering has to be combined with a reduction of target organ damage for all drug classes prescribed to patients with hypertension. Therefore, we review here the major effects of this new drug not only in regard to hypertension but also in regard to target organ damage reduction and possible changes in morbidity and mortality, which future trials will investigate.
Westermann
D
D
Department of Cardiology and Pneumology,Charité School of Medicine, Campus Benjamin Franklin, Berlin, Germany. dirk.westermann@web.de
Savvatis
K
K
Schultheiss
H P
HP
Tschöpe
C
C
D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use*; D000804:Angiotensin II / Q000502:physiology; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control*; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D004232:Diuretics / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005060:Europe / Q000453:epidemiology; D005650:Fumarates / Q000008:administration & dosage / Q000627:therapeutic use*; D005858:Germany / Q000453:epidemiology; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D006852:Hydrochlorothiazide / Q000008:administration & dosage / Q000627:therapeutic use; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D000077405:Irbesartan; D007564:Japan / Q000453:epidemiology; D015995:Prevalence; D011498:Protein Precursors / Q000502:physiology; D016032:Randomized Controlled Trials as Topic; D011956:Receptors, Cell Surface / Q000502:physiology; D012083:Renin / Q000097:blood / Q000502:physiology; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D012307:Risk Factors; D013777:Tetrazoles / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors; D014944:World Health Organization; D000093342:Prorenin Receptor; D000092502:Renin Inhibitors
D000577:Amides; D000804:Angiotensin II; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D004232:Diuretics; D005650:Fumarates; D006852:Hydrochlorothiazide; D000077405:Irbesartan; D011498:Protein Precursors; D011956:Receptors, Cell Surface; D012083:Renin; D013777:Tetrazoles; D000093342:Prorenin Receptor; D000092502:Renin Inhibitors; C446481:aliskiren