title: Two-Year Outcomes of Patients Treated With Aliskiren Under Clinical Practice Conditions: Non-Interventional Prospective Study.
abstract: The authors investigated the long-term effectiveness and safety of aliskiren (ALIS) with particular attention on its association with dual blockade of the renin-angiotensin system (RAS). The open, prospective 3A Registry (N=8723) in Germany assigned patients in a 4:1:1 ratio to ALIS, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), or non-RAS drugs. Patients taking ALIS compared with those taking ACE inhibitors/ARBs or non-RAS had more comorbidities and risk factors, were taking more antihypertensive agents, and had higher blood pressure (BP) values at entry. At 2 years, BP reduction from baseline was similar in all groups (mean, -20.5/-9.9 mm Hg). A total of 2.3% of patients died, 0.5% had myocardial infarction, 0.6% had stroke, 2.9% were hospitalized, and 5.5% had any event (not significant between groups). ALIS alone or combined with another RAS inhibitor was well tolerated and effective in lowering BP in typical unselected patients with hypertension. Given the methodical limitations of the design, the study cannot be used to confirm or refute safety concerns for dual RAS blockade as suggested by the Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE) trial.
authors.affiliation: Medizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Germany.|Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.affiliation: Helios-Klinikum Berlin-Buch, Berlin, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Dechend
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Riemer
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Evelin
authors.initials: E
authors.lastname: Deeg
authors.affiliation: Institut für Herzinfarktforschung, Ludwigshafen, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.affiliation: Institute for Clinical Pharmacology, Medical Faculty, Technical University Dresden, Dresden, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Pittrow
authors.affiliation: Department of Nephrology and Hypertension, University Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
authors.forename: Roland
authors.initials: R
authors.lastname: Schmieder
mesh_terms: D000368:Aged; D000577:Amides / Q000627:therapeutic use*; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005650:Fumarates / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000577:Amides; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D005650:Fumarates; C446481:aliskiren