TITLE

Is Aliskiren Superior to Inhibitors of Angiotensin-Converting Enzyme and Angiotensin Receptor Blockers in Renin-Angiotensin System Blockade?

AUTHOR(S)
Gerc, Vjekoslav; Buksa, Marko; Loza, Vesna; Kulic, Mehmed
PUB. DATE
December 2009
SOURCE
Medicinski Arhiv;2009, Vol. 63 Issue 6, p343
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The renin-angiotensin system (RAS) plays a crucial role in development of hypertension, heart failure, as well as in the whole process of nephropathy, particularly of diabetic nephropathy, with or without proteinuria. Blockade of RAS plays the key role in the management of hypertension and other cardiovascular diseases. Angiotensin-converting enzyme (ACE) inhibitors do not provide the full blockade of angiotensin ii because it is produced through alternative pathways. Angiotensin receptor blockers (ARBs) also block the negative feedback of angiotensin II upon renin like ACE inhibitors, leading to a several fold increase in angiotensin II levels. Aliskiren is an orally-active, nonpeptidic, direct inhibitor of renin which simultaneously reduces angiotensin I, angiotensin II and plasma renin activity (PRA). This is the main point of action of aliskiren, making it completely different from ACE inhibitors and ARBs. Aliskiren introduces a new concept into the management of hypertension. However, the question concerning its real role in the management of heart failure and its place in the existing therapeutic schemes with ACE inhibitors, ARBs, beta blockers and antagonists of aldosterone receptor, will be answered by numerous ongoing studies and clinical trials. Aliskiren shows renoprotective and antiproteinuric effects similar to those of ACE inhibitors and ARBs. The available results demonstrate that aliskiren provides a new approach to the antagonism of the RAS, offering possibilities of a more efficacious and effective treatment of hypertension, heart failure and proteinuria in diabetic patient.
ACCESSION #
47436268

 

Related Articles

  • Quinapril--A New Angiotensin-Converting Enzyme Inhibitor: An Overview. Dzau, Victor I. // Angiology;Apr1989 Part 2, Vol. 40 Issue 4, p329 

    Presents a review of the pharmacologic, biologic and side effect profile of a new nonsulfhydryl angiotensin-converting enzyme (ACE) inhibition. Evaluation of the ACE inhibitor's mechanism of action and the various aspects of its pharmacology; Assessment of its use in hypertension and congestive...

  • FOREWORD. Trimarco, Bruno // High Blood Pressure & Cardiovascular Prevention;Aug2011 Supplement, Vol. 18, p1 

    An introduction to this issue of the journal "High Blood Pressure & Cardiovascular Prevention" is presented.

  • The Role of Direct Renin Inhibition in Clinical Practice: Focus on Combination Therapy. Rashid, Haroon-Ur; Mende, Christian // American Journal of Cardiovascular Drugs;2011, Vol. 11 Issue 5, p303 

    Monotherapy with most antihypertensive agents reduces systolic BP by about 10mmHg ('Rule of 10'). Thus, the majority of hypertensive patients require combination therapy to achieve BP goals. In this review, we provide a brief overview of the renin-angiotensin-aldosterone system (RAAS) and...

  • Aliskiren, ALTITUDE, and the implications for ATMOSPHERE. McMurray, John J.V.; Abraham, William T.; Dickstein, Kenneth; Køber, Lars; Massie, Barry M.; Krum, Henry // European Journal of Heart Failure;Apr2012, Vol. 14 Issue 4, p341 

    No abstract available.

  • Antihypertensive Properties of Angiotensin-Converting Enzyme Inhibitors (ACEI) Independent of the Renin-Angiotensin System. Paiva, Therezinha Bandiera; Bravo, Jamille Cristina Rocco; Farias, Nelson Carvalho; Feres, Teresa // Current Hypertension Reviews;Aug2010, Vol. 6 Issue 3, p180 

    Angiotensin converting enzyme inhibitors (ACEi) lead to inhibition of angiotensin II formation and bradykinin inactivation. However, ACEi also have antihypertensive activity that is independent of the renin-angiotensin system. For example, the enhanced peripheral resistance due to smooth...

  • Oral Angiotensin-Converting Enzyme Inhibitor in Long-Term Treatment of Hypertensive Patients. Brunner, Hans R.; Gavras, Haralambos; Waeber, Bernard; Kershaw, Glen R.; Turini, Gustave A.; Vukovich, Robert A.; McKinstry, Doris N.; Gavras, Irene // Annals of Internal Medicine;Jan79, Vol. 90 Issue 1, p19 

    Describes the long-term effects of angiotensin-converting enzyme inhibition on blood pressure of patients with hypertension of various origins and attempts to characterize in more detail the blood-pressure-lowering properties of captopril. Types of inhibitors of the renin angiotensin system...

  • Treatment of Experimental Myocarditis via Modulation of the Renin-Angiotensin System. Daniels, Melvin D.; Hyland, Kenneth V.; Engman, David M. // Current Pharmaceutical Design;May2007, Vol. 13 Issue 13, p1299 

    The renin-angiotensin system is primarily responsible for regulating vascular tone. Drugs that inhibit this pathway, angiotensin-converting enzyme inhibitors and angiotensin receptor antagonists, are widely used to treat hypertension and a variety of cardiomyopathies. Recent studies have shown...

  • Interaction between baseline and early worsening of renal function and efficacy of renin—angiotensin—aldosterone system blockade in patients with heart failure: insights from the Val-HeFT study. Lesogor, Anastasia; Cohn, Jay N.; Latini, Roberto; Tognoni, Gianni; Krum, Henry; Massie, Barry; Zalewski, Andrew; Kandra, Albert; Hua, Tsushung A.; Gimpelewicz, Claudio // European Journal of Heart Failure;Nov2013, Vol. 15 Issue 11, p1236 

    Aims We evaluated the effect of (dual) renin–angiotensin–aldosterone system (RAAS) blockade with valsartan and an ACE inhibitor [92.7% of patients were treated with an ACE inhibitor in the Valsartan in Heart Failure Trial (Val-HeFT)] in patients with NYHA class II–IV heart...

  • Azilsartan: a new angiotensin receptor blocker. Kaschina, Elena; Unger, Thomas // Hot Topics in Hypertension;2012, Vol. 5 Issue 14, p15 

    Azilsartan medoxomil (AZL-M) is characterized by a high binding potency to the AT1 receptor, with half-maximal inhibitory concentration in the low nanomolar range for inhibiting specific binding of angiotensin II to the receptor. Pharmacodynamic studies showed that AZL-M structure determines its...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics