Document Detail


Aliskiren and valsartan combination therapy for the management of hypertension.
MedLine Citation:
PMID:  20859542     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Combination therapy is necessary for most patients with hypertension, and agents that inhibit the renin-angiotensin-aldosterone system (RAAS) are mainstays in hypertension management, especially for patients at high cardiovascular and renal risk. Single blockade of the RAAS with an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) confers some cardiorenal protection; however, these agents do not extinguish the RAAS as evidenced by a reactive increase in plasma renin activity (PRA), a cardiovascular risk marker, and incomplete cardiorenal protection. Dual blockade with an ACE inhibitor and an ARB offers no additional benefit in patients with hypertension and normal renal and left ventricular function. Indeed, PRA increases synergistically with dual blockade. Aliskiren, the first direct renin inhibitor (DRI) to become available has provided an opportunity to study the merit of DRI/ARB combination treatment. By blocking the first and rate-limiting step in the RAAS, aliskiren reduces PRA by at least 70% and buffers the compensatory increase in PRA observed with ACE inhibitors and ARBs. The combination of a DRI and an ARB or an ACE inhibitor is an effective approach for lowering blood pressure; available data indicate that such combinations favorably affect proteinuria, left ventricular mass index, and brain natriuretic peptide in patients with albuminuria, left ventricular hypertrophy, and heart failure, respectively. Ongoing outcome studies will clarify the role of aliskiren and aliskiren-based combination RAAS blockade in patients with hypertension and those at high cardiorenal risk.
Authors:
Benjamin J Epstein
Publication Detail:
Type:  Journal Article; Review     Date:  2010-09-07
Journal Detail:
Title:  Vascular health and risk management     Volume:  6     ISSN:  1178-2048     ISO Abbreviation:  Vasc Health Risk Manag     Publication Date:  2010  
Date Detail:
Created Date:  2010-09-22     Completed Date:  2010-12-03     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101273479     Medline TA:  Vasc Health Risk Manag     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  711-22     Citation Subset:  IM    
Affiliation:
Department of Pharmacotherapy, Colleges of Pharmacy and Medicine, University of Florida, Gainesville, Florida 32610-0486, USA. epstein@cop.ufl.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Amides / administration & dosage,  therapeutic use*
Angiotensin II Type 1 Receptor Blockers / administration & dosage,  therapeutic use
Angiotensin-Converting Enzyme Inhibitors / administration & dosage,  therapeutic use
Antihypertensive Agents / administration & dosage,  therapeutic use*
Blood Pressure / drug effects,  physiology
Drug Therapy, Combination
Fumarates / administration & dosage,  therapeutic use*
Humans
Hypertension / drug therapy*,  physiopathology
Renin-Angiotensin System / drug effects
Tetrazoles / administration & dosage,  therapeutic use*
Valine / administration & dosage,  analogs & derivatives*,  therapeutic use
Chemical
Reg. No./Substance:
0/Amides; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Fumarates; 0/Tetrazoles; 137862-53-4/valsartan; 502FWN4Q32/aliskiren; 7004-03-7/Valine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Role of olmesartan in combination therapy in blood pressure control and vascular function.
Next Document:  Urotensin II-induced signaling involved in proliferation of vascular smooth muscle cells.