title: Direct renin inhibition: update on clinical  investigations with aliskiren.
abstract: The renin–angiotensin–aldosterone system (RAAS) plays a pivotal role in regulating blood pressure, volume, and electrolytes. The final product of RAAS cascade is angiotensin II, which exerts diverse biological activities via binding to one of three known receptor types, with different binding consequences. Despite the success with conventional strategies to limit angiotensin II production and action, these agents promote a reflex rise in plasma renin activity, which is thought to be associated with an increased incidence of cardiovascular events. Several renin inhibitors have been synthesized in order to counteract deleterious consequences of renin activity and RAAS activation; aliskiren is the first of these new non-peptide direct renin inhibitors to be approved for the treatment of hypertension. The paper reviews pharmacokinetics of aliskiren and its role in hypertension, with particular regard to those studies that compared clinical efficacy of aliskiren in comparison and in addition to other antihypertensive drug strategies.
authors: University of Foggia, Cardiology Department, Foggia, Italy. nd.brunetti@unifg.it
authors: Natale Daniele
authors: ND
authors: Brunetti
authors: Luisa
authors: L
authors: De Gennaro
authors: Pier Luigi
authors: PL
authors: Pellegrino
authors: Andrea
authors: A
authors: Cuculo
authors: Luigi
authors: L
authors: Ziccardi
authors: Antonio
authors: A
authors: Gaglione
authors: Matteo
authors: M
authors: Di Biase
mesh_terms: D000577:Amides / Q000627:therapeutic use*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D005650:Fumarates / Q000627:therapeutic use*; D006801:Humans; D012083:Renin / Q000097:blood; D012084:Renin-Angiotensin System / Q000187:drug effects*; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D002317:Cardiovascular Agents; D005650:Fumarates; D012083:Renin; D000092502:Renin Inhibitors; C446481:aliskiren