Document Detail


Renin inhibitors: novel agents for renoprotection or a better angiotensin receptor blocker for blood pressure lowering?
MedLine Citation:
PMID:  17693755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Direct renin inhibitors are the newest antihypertensive therapeutic class. The review describes their antihypertensive and antiproteinuric effects and possible renoprotective capabilities. RECENT FINDINGS: Clinical trials demonstrate direct renin inhibitors reduce systolic and diastolic blood pressure comparable with other commonly used antihypertensive drugs, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. They also reduce proteinuria and are renoprotective in experimental models of kidney disease. Direct renin inhibitors, when used with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, offer incremental blood pressure reduction far greater than that observed when an angiotensin-converting enzyme inhibitor and angiotensin receptor blocker are used together. This suggests that renin inhibitors possess a unique and distinct mechanism of action compared with the other two therapeutic classes. SUMMARY: Direct renin inhibitors, due to their antihypertensive and antiproteinuric effects, and the unique mechanism of action resulting in reduction in plasma renin activity and suppression of angiotensin II levels, may offer a unique opportunity to facilitate blood pressure reduction with both angiotensin-converting enzyme inhibitors and angiotensin receptor blockers as well as other commonly used therapeutic classes. More effective blood pressure and proteinuria reduction coupled with a unique means of suppressing the renin angiotensin system may offer improved opportunity for renoprotection.
Authors:
Matthew R Weir
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  16     ISSN:  1062-4821     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-13     Completed Date:  2007-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  416-21     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. mweir@medicine.umaryland.edu
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MeSH Terms
Descriptor/Qualifier:
Animals
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects*
Drug Combinations
Humans
Hypertension / drug therapy*
Kidney / drug effects*,  metabolism
Models, Biological
Proteinuria / metabolism
Receptors, Angiotensin / antagonists & inhibitors*,  metabolism
Renin / antagonists & inhibitors*,  blood
Time Factors
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Drug Combinations; 0/Receptors, Angiotensin; EC 3.4.23.15/Renin

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


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