Abstract 11572: Aliskiren Improves Endothelial Function as Evaluated by Flow-Mediated Vasodilatation in Hypertensive Patients
Although accumulating evidences have demonstrated that angiotensin converting enzyme inhibitors and angiotensin receptor blockers restored endothelial dysfunction in hypertensive patients, it remains unclear whether direct renin inhibition exerts such favorable effects. We therefore performed a prospective, randomized crossover trial in which effects on endothelial function by a renin inhibitor, aliskiren (150 mg/day), and calcium channel blocker, amlodipine (5 mg/day), were compared in 29 hypertensive patients. Both treatments lasted 3 months and achieved comparable blood pressure-lowering, but aliskiren, but not amlodipine, significantly improved endothelial function as evaluated by flow-mediated vasodilation in the brachial artery (Figure A); in contrast, vasodilatory reaction to nitroglycerin remained unchanged by both drugs. As expected, aliskiren dramatically reduced plasma renin activity; in sharp contrast of significant elevation by amlodipine. Accordingly, aliskiren, but not amlodipine, significantly reduced plasma aldosterone levels. No significant changes were observed in other biochemical parameters including serum creatinine and electrolytes with either drug; however, aliskiren, but not amlodipine, reduced serum C-reactive protein levels (Figure B) and urinary excretion of albumin as compared to baseline. In conclusions, through global RAAS blockade, direct renin inhibition using aliskiren improved endothelial function and exerted an anti-inflammatory property in hypertensive patients independent of its blood pressure-lowering effect. Therefore, aliskiren might provide a greater long term benefit for hypertensive patients with impaired endothelial function.
- © 2012 by American Heart Association, Inc.