Safety and efficacy of  aliskiren  in the treatment of hypertension: a systematic overview.
BACKGROUND
Aliskiren is the first orally active direct renin inhibitor approved for the treatment of hypertension. Aliskiren's inhibitory effect on angiotensin I generation, through renin blockade, is highly specific and long-lasting (24 hours). This feature differentiates aliskiren from traditional antihypertensive drugs.


METHODS
This paper reviews the results of various clinical trials which investigate the safety and efficacy of aliskiren on blood pressure (BP) reduction and clinical end points.


CONCLUSIONS
Aliskiren is suitable for once-daily administration. Its antihypertensive effect is comparable or superior to that of other antihypertensive agents at recommended doses. The tolerability profile of aliskiren is placebo-like at the licensed doses of 150 and 300 mg. In particular, the discontinuation of therapy due to clinical adverse events occurs similarly among patients treated with either aliskiren or placebo. Aliskiren is not recommended in association with ACE-inhibitors or angiotensin II receptor blockers in patients with type 2 diabetes and renal impairment. Pending disclosure of full results, the early termination of the ALTITUDE seems to confirm previous concerns about the safety of the dual pharmacological blockade of the renin-angiotensin system in these patients. Aliskiren is a well-tolerated antihypertensive drug that may help to achieve the recommended targets of BP control.
Hospital Media Valle del Tevere - Pantalla, AUSL 2 Umbria, Department of Cardiology, Section of Cardiology, Perugia, Italy. fangeli@cardionet.it
Fabio
F
Angeli
Gianpaolo
G
Reboldi
Giovanni
G
Mazzotta
Cristina
C
Poltronieri
Paolo
P
Verdecchia
D000577:Amides / Q000009:adverse effects* / Q000191:economics / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005650:Fumarates / Q000009:adverse effects* / Q000191:economics / Q000494:pharmacology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*
D000577:Amides; D000959:Antihypertensive Agents; D005650:Fumarates; C446481:aliskiren