title: Efficacy of aliskiren and valsartan in hypertensive patients with albuminuria: a randomized parallel-group study.
abstract: BACKGROUND
  Blockade of the renin-angiotensin system (RAS) is a critical approach to the management of hypertension, especially in proteinuric patients. It is well proven that the direct renin inhibitor aliskiren shows comparable clinical efficacy to the angiotensin II receptor blocker valsartan on blood pressure control and albuminuria. However, there is only limited data on the hand-to-hand effectiveness of these two RAS blockers in improving arterial stiffness. We tested whether aliskiren or valsartan would improve arterial stiffness in hypertensive patients with albuminuria who are already on antihypertensive therapy.
  
  
  METHODS
  Thirty-four patients with hypertension and albuminuria < 1 g, after a wash-out period of three weeks, were randomized to aliskiren or valsartan in a 24-week randomized parallel-group study.
  
  
  RESULTS
  A nonsignificant difference in blood pressure was seen between the two treatment groups. Albuminuria was significantly reduced in both groups (56% for the aliskiren group, p < 0.05, and 38% for the valsartan group, p < 0.05). Only valsartan but not aliskiren significantly reduced carotid-femoral pulse wave velocity (-1.1 ± 0.8 m/s (p = 0.02) for valsartan and +0.1 ± 0.7 m/s (ns) for aliskiren).
  
  
  CONCLUSIONS
  The results of our study showed that valsartan improves arterial stiffness to a significantly greater extent than aliskiren, despite a similar antihypertensive and antiproteinuric effect.
authors.affiliation: Outpatient Renal Clinic, University Hospital of Ioannina, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Spanos
authors.forename: Rigas
authors.initials: R
authors.lastname: Kalaitzidis
authors.forename: Despina
authors.initials: D
authors.lastname: Karasavvidou
authors.forename: Kosmas
authors.initials: K
authors.lastname: Pappas
authors.forename: Kostas C
authors.initials: KC
authors.lastname: Siamopoulos
mesh_terms: D000419:Albuminuria / Q000150:complications* / Q000188:drug therapy*; D000577:Amides / Q000494:pharmacology / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003710:Demography; D005260:Female; D005650:Fumarates / Q000494:pharmacology / Q000627:therapeutic use*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis; D013777:Tetrazoles / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D005650:Fumarates; D013777:Tetrazoles; C446481:aliskiren; D000068756:Valsartan; D014633:Valine
keywords: Aliskiren; albuminuria; arterial hypertension; arterial stiffness; pulse wave velocity; valsartan