| Aliskiren and valsartan combination therapy for the management of hypertension. | |
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MedLine Citation:
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PMID: 20859542 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Benjamin J Epstein |
Publication Detail:
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Type: Journal Article; Review Date: 2010-09-07 |
Journal Detail:
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Title: Vascular health and risk management Volume: 6 ISSN: 1178-2048 ISO Abbreviation: Vasc Health Risk Manag Publication Date: 2010 |
Date Detail:
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Created Date: 2010-09-22 Completed Date: 2010-12-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101273479 Medline TA: Vasc Health Risk Manag Country: New Zealand |
Other Details:
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Languages: eng Pagination: 711-22 Citation Subset: IM |
Affiliation:
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Department of Pharmacotherapy, Colleges of Pharmacy and Medicine, University of Florida, Gainesville, Florida 32610-0486, USA. epstein@cop.ufl.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amides
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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:
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0/Amides; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Fumarates; 0/Tetrazoles; 0/aliskiren; 137862-53-4/valsartan; 7004-03-7/Valine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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