Document Detail

Unmet needs in managing hypertension: potential role of direct renin inhibition.
MedLine Citation:
PMID:  20463431     Owner:  NLM     Status:  MEDLINE    
Hypertension is the most prevalent and important risk factor for cardiovascular and renal disease worldwide. Despite the large armamentarium of available blood pressure-lowering agents, the need remains for safer and more effective antihypertensive treatment. Based on current target levels of < 140/90 mm Hg, only one-third of hypertensive Americans have achieved goal blood pressure. Several strategies can help address these challenges, including increasing public awareness, and improving physician awareness of evidence-based therapeutic guidelines. There also remains a need for new therapeutic options. This review examines new developments among those agents having inhibitory activity on the renin-angiotensin-aldosterone system (RAAS). All currently available RAAS blockers cause a reactive increase in plasma renin concentration. However, the direct renin inhibitors are the only class that diminishes plasma renin activity, an effect that may provide additional cardiovascular and/or renoprotective benefit. Aliskiren is the first clinically available direct renin inhibitor that has been shown to be effective and well tolerated both as monotherapy and in combination with other established agents in hypertensive patients. Randomized clinical trials are underway to explore the extent to which direct renin inhibition provides additive protection against cardiovascular and renal disease events.
Michael C Ruddy
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Postgraduate medicine     Volume:  122     ISSN:  1941-9260     ISO Abbreviation:  Postgrad Med     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-13     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401147     Medline TA:  Postgrad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-12     Citation Subset:  AIM; IM    
University Medical Center at Princeton, NJ, USA.
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MeSH Terms
Amides / therapeutic use*
Antihypertensive Agents / therapeutic use
Diabetes Complications
Drug Therapy, Combination
Fumarates / therapeutic use*
Healthy People Programs
Heart Failure / complications
Hypertension / complications,  drug therapy*,  physiopathology
Middle Aged
Obesity / complications
Renin / antagonists & inhibitors*
Renin-Angiotensin System / physiology
Reg. No./Substance:
0/Amides; 0/Antihypertensive Agents; 0/Fumarates; 0/aliskiren; EC

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

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