Comparative effects of aliskiren-based and ramipril-based therapy on the renin system during long-term (6 months) treatment and withdrawal in patients with hypertension
| Autor: | Mohammed Atif Ali, James Jin, Christian C. Constance, Margaret F. Prescott, Karl Andersen, Deborah L. Keefe, Myron H. Weinberger |
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| Rok vydání: | 2009 |
| Předmět: |
Ramipril
Male Medicine (General) medicine.medical_specialty animal structures Time Factors Systole medicine.medical_treatment Urology Blood Pressure Pharmacology Placebo Plasma renin activity Renin-Angiotensin System chemistry.chemical_compound R5-920 Endocrinology Hydrochlorothiazide Fumarates Diastole Internal medicine Renin–angiotensin system Renin Internal Medicine Medicine Albuminuria Humans Antihypertensive Agents Demography business.industry Aliskiren Middle Aged Amides chemistry Creatinine ACE inhibitor Hypertension Female Diuretic business Biomarkers medicine.drug |
| Zdroj: | Journal of the Renin-Angiotensin-Aldosterone System, Vol 10 (2009) |
| ISSN: | 1752-8976 |
| Popis: | Introduction. This subgroup analysis assessed the effects of treatment based on the direct renin inhibitor, aliskiren, or the angiotensin-converting enzyme inhibitor, ramipril, on plasma renin activity (PRA), plasma renin concentration (PRC) and other biomarkers in a 26-week randomised, double-blind trial. Changes in PRA and PRC after stopping treatment were also assessed. Methods. After placebo run-in, 842 patients (mean sitting diastolic blood pressure (BP) 95—109 mmHg) were randomised to aliskiren 150 mg or ramipril 5 mg. Dose titration and hydrochlorothiazide addition were allowed after Week 6 and 12, respectively, for inadequate BP control. Patients completing active treatment were re-randomised to current regimen or placebo during a 4-week posttreatment phase. Results. BP reductions were independent of baseline PRA at Week 12, were greater with aliskiren- than ramipril-based therapy at Week 26 (17.9/13.3 vs. 15.2/12.0 mmHg, p Conclusions. Aliskiren-based therapy produced sustained BP and PRA reductions over 26 weeks; ramipril-based therapy lowered BP and increased PRA. PRA reductions persisted 4 weeks after stopping aliskiren, suggesting an inhibitory effect beyond the elimination half-life of the drug. |
| Databáze: | OpenAIRE |
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