What question did this study set out to answer?

To determine whether direct renin inhibition with aliskiren prevents reactive increases in plasma renin activity and enhances blood pressure reduction when combined with standard antihypertensive medications.

December 12, 2006HypertensionOpen Access

Aliskiren Reduces Blood Pressure and Suppresses Plasma Renin Activity in Combination With a Thiazide Diuretic, an Angiotensin-Converting Enzyme Inhibitor, or an Angiotensin Receptor Blocker

Q: What is the clinical evidence from this study?

Study design: Other. Population: mild-to-moderate hypertension (n=67). Intervention: Aliskiren vs. Monotherapy with hydrochlorothiazide, ramipril, or irbesartan. Primary outcome: daytime and nighttime blood pressure and plasma renin activity (p=<0.0001).

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Key result

Adding aliskiren to hydrochlorothiazide, ramipril, or irbesartan significantly lowered blood pressure and suppressed reactive increases in plasma renin activity (P<0.0001 for renin inhibition).

Why the study?

Does aliskiren added to hydrochlorothiazide, ramipril, or irbesartan improve blood pressure control and suppress plasma renin activity in patients with mild-to-moderate hypertension?

Population

67 patients with mild-to-moderate hypertension (n=23 in diuretic study, n=21 in ACEi study, n=23 in ARB study)

Comparison

Aliskiren added to hydrochlorothiazide… vs Monotherapy with aliskiren, ramipril, or…

Design

Cohort, open-label

Follow-up

3 weeks

Authors

EOEoin OʼBrienPreventive Cardiology JBJohn BartonUniversity College Dublin JNJuerg NussbergerUniversity of Lausanne

Discussion

Member takes

Implication

May support aliskiren addition for BP lowering in mild hypertension; leaves open efficacy and safety in randomized trials.

Key Points

To determine whether direct renin inhibition with aliskiren prevents reactive increases in plasma renin activity and enhances blood pressure reduction when combined with standard antihypertensive medications.
Conducted 3 open-label studies assessing 24-hour ambulatory blood pressure in patients with mild-to-moderate hypertension treated for 3 weeks with aliskiren combinations: hydrochlorothiazide (n=23), ramipril (n=21), or irbesartan (n=23).
Adding hydrochlorothiazide (25 mg) to aliskiren (150 mg) lowered daytime BP by -18.4/-10.6 mmHg versus -10.4/-5.8 mmHg for aliskiren monotherapy; adding aliskiren (75 or 150 mg) to ramipril (5 mg) or irbesartan (150 mg) also produced greater daytime and nighttime BP reductions than monotherapy.
Aliskiren monotherapy (150 mg) inhibited plasma renin activity by 65% (P<0.0001) and prevented reactive rises induced by ramipril (+90%) and irbesartan (+175%), maintaining median plasma renin activity at 0.4–0.5 ng/mL/h versus 0.6–0.7 ng/mL/h untreated.

Structured PICO

Does aliskiren added to hydrochlorothiazide, ramipril, or irbesartan improve blood pressure control and suppress plasma renin activity in patients with mild-to-moderate hypertension?

Population

67 patients with mild-to-moderate hypertension treated with aliskiren in combination with hydrochlorothiazide, ramipril, or irbesartan for 3 weeks.

Intervention

Aliskiren (75 mg or 150 mg daily) added to hydrochlorothiazide (25 mg), ramipril (5 mg), or irbesartan (150 mg) for 3 weeks

Comparator

Monotherapy with aliskiren, ramipril, or irbesartan

Outcome

Daytime and nighttime ambulatory blood pressure and plasma renin activity at 3 weekssurrogate

Main Result

p-value: p=<0.0001

Adding the direct renin inhibitor aliskiren to standard antihypertensive therapies improves 24-hour blood pressure control and suppresses reactive rises in plasma renin activity.

Cite This Study

OʼBrien et al. (2006) studied mild-to-moderate hypertension (n=67). Aliskiren vs. Monotherapy with hydrochlorothiazide, ramipril, or irbesartan was evaluated on daytime and nighttime blood pressure and plasma renin activity (p=<0.0001). Adding aliskiren to hydrochlorothiazide, ramipril, or irbesartan significantly lowered blood pressure and suppressed reactive increases in plasma renin activity (P<0.0001 for renin inhibition).

synapsesocial.com/papers/6a75b68c50ae15bd7fd3782b https://doi.org/10.1161/01.hyp.0000253780.36691.4f

Topics

Hypertension management

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December 12, 2006HypertensionOpen Access

Aliskiren Reduces Blood Pressure and Suppresses Plasma Renin Activity in Combination With a Thiazide Diuretic, an Angiotensin-Converting Enzyme Inhibitor, or an Angiotensin Receptor Blocker

View Full Paper

Ask AI

Bookmark

Key result

Adding aliskiren to hydrochlorothiazide, ramipril, or irbesartan significantly lowered blood pressure and suppressed reactive increases in plasma renin activity (P<0.0001 for renin inhibition).

Why the study?

Does aliskiren added to hydrochlorothiazide, ramipril, or irbesartan improve blood pressure control and suppress plasma renin activity in patients with mild-to-moderate hypertension?

Population

67 patients with mild-to-moderate hypertension (n=23 in diuretic study, n=21 in ACEi study, n=23 in ARB study)

Comparison

Aliskiren added to hydrochlorothiazide… vs Monotherapy with aliskiren, ramipril, or…

Design

Cohort, open-label

Follow-up

3 weeks

Authors

EOEoin OʼBrienPreventive Cardiology JBJohn BartonUniversity College Dublin JNJuerg NussbergerUniversity of Lausanne

Discussion

Member takes

Implication

May support aliskiren addition for BP lowering in mild hypertension; leaves open efficacy and safety in randomized trials.

Key Points

To determine whether direct renin inhibition with aliskiren prevents reactive increases in plasma renin activity and enhances blood pressure reduction when combined with standard antihypertensive medications.
Conducted 3 open-label studies assessing 24-hour ambulatory blood pressure in patients with mild-to-moderate hypertension treated for 3 weeks with aliskiren combinations: hydrochlorothiazide (n=23), ramipril (n=21), or irbesartan (n=23).
Adding hydrochlorothiazide (25 mg) to aliskiren (150 mg) lowered daytime BP by -18.4/-10.6 mmHg versus -10.4/-5.8 mmHg for aliskiren monotherapy; adding aliskiren (75 or 150 mg) to ramipril (5 mg) or irbesartan (150 mg) also produced greater daytime and nighttime BP reductions than monotherapy.
Aliskiren monotherapy (150 mg) inhibited plasma renin activity by 65% (P<0.0001) and prevented reactive rises induced by ramipril (+90%) and irbesartan (+175%), maintaining median plasma renin activity at 0.4–0.5 ng/mL/h versus 0.6–0.7 ng/mL/h untreated.

Structured PICO

Does aliskiren added to hydrochlorothiazide, ramipril, or irbesartan improve blood pressure control and suppress plasma renin activity in patients with mild-to-moderate hypertension?

Population

67 patients with mild-to-moderate hypertension treated with aliskiren in combination with hydrochlorothiazide, ramipril, or irbesartan for 3 weeks.

Intervention

Aliskiren (75 mg or 150 mg daily) added to hydrochlorothiazide (25 mg), ramipril (5 mg), or irbesartan (150 mg) for 3 weeks

Comparator

Monotherapy with aliskiren, ramipril, or irbesartan

Outcome

Daytime and nighttime ambulatory blood pressure and plasma renin activity at 3 weekssurrogate

Main Result

p-value: p=<0.0001

Adding the direct renin inhibitor aliskiren to standard antihypertensive therapies improves 24-hour blood pressure control and suppresses reactive rises in plasma renin activity.

Cite This Study

synapsesocial.com/papers/6a75b68c50ae15bd7fd3782b https://doi.org/10.1161/01.hyp.0000253780.36691.4f

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

Topics

Hypertension management

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