This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Brown, M. J. Search for Related Content PubMed PubMed Citation Articles by Brown, M. J. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Blood Pressure Medicines High Blood Pressure Related Collections Other hypertension

(Circulation. 2008;118:773-784.)
© 2008 American Heart Association, Inc.

New Drugs and Technologies

Aliskiren

Morris J. Brown, FMedSci

From the University of Cambridge, Cambridge, UK.

Correspondence to Morris J. Brown, FMedSci, FAHA, Clinical Pharmacology Unit, Box 110, Addenbrookes Hospital, Cambridge, CB3 9AA, UK. E-mail m.j.brown{at}cai.cam.ac.uk

Aliskiren is the first orally active inhibitor of renin to be approved for clinical use as an antihypertensive agent. The development program has established that at the licensed doses of 150 mg and 300 mg, there are dose-related falls in blood pressure comparable to those seen with other major classes of antihypertensive drugs and that these falls are associated with a placebo level of side effects. Aliskiren was found to be effective either as monotherapy or in combination with drugs from the other major classes. As expected, there was a greater benefit from adding aliskiren to natriuretic drugs than to other blockers of the renin system. However, there was also some consistent benefit from dual renin blockade. Aliskiren is likely to be of most value in patients uncontrolled by, or intolerant of, other classes. Rational understanding of the renin system will maximize its value, for instance, by encouraging greater use of natriuretic agents in patients with resistant hypertension to render their hypertension renin dependent. Whether there are cardiovascular benefits other than blood pressure control in blocking the renin system remains to be demonstrated. It is hoped that long-term outcome studies with aliskiren will finally allow this question to be answered.

Key Words: aliskiren • renin • renin inhibitor

This article has been cited by other articles:

				P. S Sever, A. H Gradman, and M. Azizi Managing cardiovascular and renal risk: the potential of direct renin inhibition Journal of Renin-Angiotensin-Aldosterone System, June 1, 2009; 10(2): 65 - 76. [Abstract] [PDF]

				Y. Yu, M. B. Lucitt, J. Stubbe, Y. Cheng, U. G. Friis, P. B. Hansen, B. L. Jensen, E. M. Smyth, and G. A. FitzGerald Prostaglandin F2{alpha} elevates blood pressure and promotes atherosclerosis PNAS, May 12, 2009; 106(19): 7985 - 7990. [Abstract] [Full Text] [PDF]