Aliskiren: beyond blood pressure reduction.
BACKGROUND
Hypertension is one of the most important risk factors and causes of cardiovascular disease (CVD). From some years, renin-angiotensin-aldosterone system (RAAS) inhibitors such angiotensin converting enzyme (ACE) and angiotensin receptor blockade (ARB) have been of interest, not only for better blood pressure (BP) control but also for their involvement in the mechanisms of various organ functions.


METHODS
The aim of this review is to focus on the effectiveness and safety of aliskiren beyond the treatment of hypertension.


RESULTS
Aliskiren, the first approved renin inhibitor to reach the market, is a low-molecular-weight, orally active, hydrophilic non-peptide molecule that blocks angiotensin I generation. Because of its mechanism of action, aliskiren may offer the additional opportunity to inhibit progression of atherosclerosis at tissue level and the potential to be useful in a wide spectrum of conditions. However, we will discuss how it might become a reasonable therapeutic choice also in a broad number of clinical conditions, sharing an increased cardiovascular risk as stable coronary artery disease (CAD), microvascular and cardio-renal disease, diabetes, and peripheral arterial disease (PAD).


CONCLUSIONS
Therapy of hypertension through a better blockade of RAAS may be the first step in also achieving interesting results in the complications that hypertension causes in several organs.
Riccioni
Graziano
G
Cardiology Unit, San Camillo Hospital, via Isonzo, 71043 Manfredonia, Foggia, Italy. griccioni@hotmail.com
Vitulano
Nicola
N
Zanasi
Alessandra
A
Bellocci
Fulvio
F
d'Orazio
Nicolantonio
N
D000577:Amides / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D000818:Animals; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D018450:Disease Progression; D004353:Drug Evaluation, Preclinical; D004359:Drug Therapy, Combination; D005650:Fumarates / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D051381:Rats; D012083:Renin / Q000502:physiology; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D000092502:Renin Inhibitors
D000577:Amides; D000959:Antihypertensive Agents; D005650:Fumarates; D012083:Renin; D000092502:Renin Inhibitors; C446481:aliskiren