Aliskiren
Aliskiren
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DOI：
10.1161/circulationaha.108.787630
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发表时间：
2008-08-12
期刊：
影响因子：
37.8
通讯作者：
Brown, Morris J.
中科院分区：
文献类型：
--
作者：
Brown, Morris J.
阿利吉仑是第一个被批准用于临床的口服活性肾素抑制剂作为抗高血压药。开发项目已确定，在150 mg和300 mg许可剂量下，血压出现与其他主要类别降压药物相当的剂量相关福尔斯下降，并且这些福尔斯下降与安慰剂水平的副作用相关。阿利吉仑被发现是有效的，无论是作为单一药物或与其他主要类别的药物组合。正如预期的那样，阿利吉仑与利钠尿肽药物联合使用比与其他肾素系统阻滞剂联合使用获益更大。然而，双重肾素阻断也有一些一致的益处。阿利吉仑可能是最有价值的患者不受控制，或不耐受，其他类。对肾素系统的合理理解将使其价值最大化，例如，鼓励顽固性高血压患者更多地使用利钠剂，使其高血压依赖于肾素。阻断肾素系统是否对心血管系统有除血压控制以外的益处还有待证实。希望阿利吉仑的长期结果研究最终能回答这个问题。
Aliskiren is the first orally active inhibitor of renin to be approved for clinical use as an antihypertensive agent. The development program has established that at the licensed doses of 150 mg and 300 mg, there are dose-related falls in blood pressure comparable to those seen with other major classes of antihypertensive drugs and that these falls are associated with a placebo level of side effects. Aliskiren was found to be effective either as monotherapy or in combination with drugs from the other major classes. As expected, there was a greater benefit from adding aliskiren to natriuretic drugs than to other blockers of the renin system. However, there was also some consistent benefit from dual renin blockade. Aliskiren is likely to be of most value in patients uncontrolled by, or intolerant of, other classes. Rational understanding of the renin system will maximize its value, for instance, by encouraging greater use of natriuretic agents in patients with resistant hypertension to render their hypertension renin dependent. Whether there are cardiovascular benefits other than blood pressure control in blocking the renin system remains to be demonstrated. It is hoped that long-term outcome studies with aliskiren will finally allow this question to be answered.