Effectiveness of the direct renin inhibitor, aliskiren, in patients with resistant hypertension
| Autor: | Yuichi Saitou, Kazuo Minai, Yasuhiro Tarutani, Ken-ichi Kawanishi, Takashi Tsujibayashi, Satoru Suwa, Masashi Kaneki, Shun-ichiro Sakurai, Akihisa Yamaguchi, Yuji Yoshitomi, Toshikazu Ishii |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Diastole Resistant hypertension chemistry.chemical_compound Fumarates Internal medicine Renin DIRECT RENIN INHIBITOR Medicine Humans In patient Antihypertensive Agents Aged Aged 80 and over Salvage Therapy business.industry General Medicine Aliskiren Middle Aged Amides Pulse pressure Mean blood pressure Blood pressure Logistic Models Treatment Outcome chemistry Hypertension Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | International heart journal. 54(2) |
| ISSN: | 1349-3299 |
| Popis: | Currently there is no consensus regarding which add-on therapy to use in resistant hypertension. We have conducted an open observational study of the use of aliskiren in resistant hypertensive patients. Forty-three patients with resistant hypertension were included in the study. The inclusion criteria were as follows: 1) office blood pressure (BP) > 140/90 mmHg despite treatment with at least three or more antihypertensive drugs; 2) no prior therapy with aliskiren; and 3) no renal insufficiency. Follow-up BP was determined at 1 and 3 months. Baseline BP was 153 ± 12/79 ± 12 mmHg. After 3 months, systolic BP (SBP) and diastolic BP (DBP) dropped significantly: 140 ± 19/73 ± 13 mmHg (P < 0.0001). Twenty-one patients (49%) had an office BP < 140/90 mmHg, and these patients were assigned to the good BP control group. Another 22 were placed into the poor BP control group. BP reductions from baseline in the good BP control group (SBP/ DBP: 19 ± 11/8 ± 7 mmHg) were larger than those in the poor BP control group (5 ± 15/3 ± 9 mmHg, P < 0.05). Mean BP (MBP) values at baseline, 1, and 3 months were higher in the poor BP control group. There was no significant difference in pulse pressure at baseline between the 2 groups. In multivariate analysis, only MBP at baseline correlated with lack of BP control. Aliskiren administration to resistant hypertensive patients was effective in reducing BP. The present findings suggest aliskiren may be useful as a fourth-line or fifth-line treatment added to other drugs in the treatment of resistant hypertension. |
| Databáze: | OpenAIRE |
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