title: Effect of add-on aliskiren to type 1 angiotensin receptor blocker therapy on endothelial function and autonomic nervous system in hypertensive patients with ischemic heart disease.
abstract: The aim of this study was to evaluate the add-on effect of aliskiren to valsartan on endothelial-dependent vasodilation in hypertensive patients with ischemic heart disease (IHD). After 4 weeks of treatment with 80 mg of valsartan, 28 patients were allocated to either continued treatment with valsartan or an add-on treatment with valsartan plus 150 mg of aliskiren. Aliskiren significantly decreased plasma renin activity, whereas endothelium-dependent vasodilation measured by flow-mediated dilation (FMD) did not change. In contrast, heart rate significantly decreased (73.1 ± 9.8 to 66.3 ± 7.0 beats per minute at baseline and 24 weeks, respectively [P = .009]) and the standard deviation of the R-R intervals (SDNN) significantly increased in the aliskiren group. The add-on aliskiren to valsartan therapy may not improve endothelial functions, although it significantly reduced resting heart rate via regulation of the autonomic nervous system in hypertensive patients with IHD.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Ozeki
authors.forename: Eisuke
authors.initials: E
authors.lastname: Amiya
authors.forename: Masafumi
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Hosoya
authors.forename: Munenori
authors.initials: M
authors.lastname: Takata
authors.forename: Aya
authors.initials: A
authors.lastname: Watanabe
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kawarasaki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Nakao
authors.forename: Shogo
authors.initials: S
authors.lastname: Watanabe
authors.forename: Kazuko
authors.initials: K
authors.lastname: Omori
authors.forename: Namie
authors.initials: N
authors.lastname: Yamada
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Tahara
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hirata
authors.forename: Ryozo
authors.initials: R
authors.lastname: Nagai
mesh_terms: D000368:Aged; D000577:Amides / Q000494:pharmacology* / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001341:Autonomic Nervous System / Q000187:drug effects* / Q000502:physiology; D015897:Comorbidity; D004359:Drug Therapy, Combination; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000502:physiology; D005260:Female; D005650:Fumarates / Q000494:pharmacology* / Q000627:therapeutic use; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D012083:Renin / Q000378:metabolism; D013777:Tetrazoles / Q000494:pharmacology* / Q000627:therapeutic use; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D000068756:Valsartan; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D005650:Fumarates; D012083:Renin; D013777:Tetrazoles; D014633:Valine; D000068756:Valsartan; D000092502:Renin Inhibitors; C446481:aliskiren