title: Antihypertensive Efficacy of the Direct Renin Inhibitor Aliskiren as Add-on Therapy in Patients with Poorly Controlled Hypertension.
abstract: OBJECTIVE
  A direct renin inhibitor, aliskiren, has a longer stable antihypertensive effect compared with other renin-angiotensin-aldosterone system (RAAS) inhibitors.
  
  
  METHODS
  This study was a 6-month, single-center, open trial conducted between December 2010 and November 2011 to assess the antihypertensive effect of adding aliskiren (300 mg) to the treatment of essential hypertension patients whose target blood pressure (BP) had not been achieved and to assess whether it was possible to reduce the amount of antihypertensive drugs used.
  
  
  RESULTS
  The results showed an overall improvement in the target BP achievement rate of 60% for clinic BP and 52% for home BP measurements (75 cases total). The mean number of drugs before treatment with aliskiren was 3.28±1.52, whereas at the end of the six months the mean number of drugs prescribed other than aliskiren was 2.85±1.72 (p<0.0001). Moreover, no worsening of the renal function was observed in patients with diabetes or chronic kidney disease (CKD) who were being treated with other RAAS inhibitors in combination to aliskiren.
  
  
  CONCLUSIONS
  These results showed that when aliskiren was added to the treatment of poorly controlled hypertension, the BP achievement rate increased, and it was possible to reduce the amount of antihypertensive drugs used in combination with aliskiren. Moreover, as a result of careful monitoring of the renal function or decreasing the amounts of drugs used in combination, no worsening of the renal function was observed even in the cases complicated by diabetes or CKD being treated with other RAAS inhibitors.
authors.affiliation: Department of Health Planning Center, Nihon University Hospital, Japan.
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Tani
authors.forename: Toshio
authors.initials: T
authors.lastname: Kushiro
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Takahashi
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawamata
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Ohkubo
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000368:Aged; D000577:Amides / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D004334:Drug Administration Schedule; D005260:Female; D005650:Fumarates / Q000008:administration & dosage*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007564:Japan; D008297:Male; D012084:Renin-Angiotensin System / Q000187:drug effects*; D016896:Treatment Outcome; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D000959:Antihypertensive Agents; D005650:Fumarates; D000092502:Renin Inhibitors; C446481:aliskiren