Current Vascular Pharmacology

Dimitri P. Mikhailidis  
Academic Head, Deptartment of Clinical Biochemistry
Royal Free Hospital Campus
University College London Medical School
University College London (UCL)
Pond Street
London, NW3 2QG
UK

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Aliskiren in Patients with Diabetes: A Systematic Review

Author(s): Evangelos C. Rizos, Aris P. Agouridis and Moses S. Elisaf

Affiliation: Department of Internal Medicine,Medical School, University of Ioannina, 45110 Ioannina, Greece.

Keywords: Aliskiren, diabetes mellitus, albuminuria, hypertension, nephropathy, blood pressure, angiotensin converting enzyme (ACE), angiotensin receptor blocker, CVD, CKD

Abstract:

Objective: Diabetic patients are at risk of macro- and micro-vascular complications, including diabetic nephropathy, and have difficulties in achieving blood pressure (BP) goals. Aliskiren, a direct renin inhibitor, inhibits the first step of the renin angiotensin aldosterone system. We aimed to systematically address the relevant evidence on the effects of aliskiren in diabetic individuals. Methods: We considered randomized controlled trials (RCTs) evaluating aliskiren in diabetic patients. Information was recorded independently by 2 investigators. We were limited to trials published in English. Results: PubMed search retrieved 16 items. After excluding 12, we ended with 4 eligible studies with 1488 participants. Mean baseline BP levels were 143/82 mmHg and median follow up was 2 months. Aliskiren was compared against angiotensin converting enzyme (ACE) inhibitor/angiotensin receptor blocker (ARB) or aliskiren plus ACE inhibitor/ARB in 2 studies and against placebo in the other 2. The most frequent indication for aliskiren therapy was diabetes plus hypertension and albuminuria. Aliskiren seems to be effective in reducing BP levels, albuminuria in diabetics, either as monotherapy (compared with placebo), or in addition to ACE inhibitors/ARB (compared with monotherapy), without any major safety considerations. Conclusions: There are promising results on the effect of aliskiren in diabetic patients, but the available evidence is limited so far. This is a poorly investigated field with few RCTs and new studies focusing on “hard” outcomes are needed.

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Article Details

VOLUME: 10
ISSUE: 2
Page: [140 - 146]
Pages: 7
DOI: 10.2174/157016112799305094