What question did this study set out to answer?

To evaluate the effects of the oral direct renin inhibitor aliskiren compared with irbesartan and placebo on plasma renin activity, active renin concentration, and systolic blood pressure in hypertension.

May 1, 2005American Journal of Hypertension

Changes in plasma renin match the antihypertensive effects of aliskiren in patients with hypertension: Placebo/irbesartan-controlled trial with the orally active renin inhibitor aliskiren

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Why the study?

Does aliskiren reduce sitting systolic blood pressure and plasma renin activity in patients with mild to moderate hypertension?

Population

569 patients with mild to moderate hypertension

Comparison

Aliskiren once daily oral for 8 weeks vs Irbesartan 150 mg or placebo once daily oral for…

Design

RCT

Follow-up

8 weeks

Authors

JNJ NussbergerUniversity Hospital of Lausanne AGAlan H. GradmanNorthwestern University RSR. SchmiederUniversitätsklinikum Erlangen

Discussion

Member takes

Implication

Aliskiren matches irbesartan SBP reduction while suppressing PRA; confirms direct renin inhibition as an effective RAS blockade strategy in hypertension.

Key Points

To evaluate the effects of the oral direct renin inhibitor aliskiren compared with irbesartan and placebo on plasma renin activity, active renin concentration, and systolic blood pressure in hypertension.
Conducted an 8-week placebo- and active-controlled trial in 569 patients with mild to moderate hypertension (baseline sitting blood pressure 152±12/99±4 mmHg).
Patients received once-daily oral doses of aliskiren (150 mg, 300 mg, or 600 mg), irbesartan (150 mg), or placebo.
Plasma renin activity (via antibody trapping), plasma active renin concentration, and sitting systolic blood pressure were measured before and after 8 weeks.
Aliskiren reduced plasma renin activity by 69% (150 mg), 71% (300 mg), and 75% (600 mg), whereas irbesartan 150 mg doubled plasma renin activity.
Aliskiren 150 mg achieved equivalent increases in active renin concentration and matched systolic blood pressure reduction compared with irbesartan 150 mg.
Higher aliskiren doses (300 mg and 600 mg) led to significantly greater increases in active renin concentration versus irbesartan 150 mg (p<0.05) and further systolic blood pressure reductions.

Structured PICO

Does aliskiren reduce sitting systolic blood pressure and plasma renin activity in patients with mild to moderate hypertension?

Population

569 patients with mild to moderate hypertension

Intervention

Aliskiren (150, 300 or 600 mg) once daily oral for 8 weeks

Comparator

Irbesartan 150 mg or placebo once daily oral for 8 weeks

Outcome

Plasma renin activity (PRA), plasma active renin concentration (ARC), and sitting systolic blood pressure (SBP) at 8 weekssurrogate

Aliskiren provides dose-dependent renin-angiotensin system blockade and blood pressure reduction comparable to irbesartan in patients with mild to moderate hypertension.

Cite This Study

Nussberger et al. (2005) studied this question.

synapsesocial.com/papers/6a7ee1376e4b721fcdc2fd63 https://doi.org/10.1016/j.amjhyper.2005.03.641

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Implication

Aliskiren matches irbesartan SBP reduction while suppressing PRA; confirms direct renin inhibition as an effective RAS blockade strategy in hypertension.

Changes in plasma renin match the antihypertensive effects of aliskiren in patients with hypertension: Placebo/irbesartan-controlled trial with the orally active renin inhibitor aliskiren

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Changes in plasma renin match the antihypertensive effects of aliskiren in patients with hypertension: Placebo/irbesartan-controlled trial with the orally active renin inhibitor aliskiren

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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