Aliskiren (Rasilez®)

Classe pharmacothérapeutique : Inhibiteur de la rénine, c


L'aliskiren est un inhibiteur direct de l'activité de la rénine humaine, non peptidique, sélectif et puissant, actif par voie orale.


comment ça marche

En inhibant l'enzyme rénine, l'aliskiren inhibe le SRA au point d'activation, en bloquant la conversion de l'angiotensinogène en angiotensine I et en réduisant les taux d'angiotensine I et d'angiotensine II. Alors que d'autres inhibiteurs du SRA (IEC et antagonistes des récepteurs de l'angiotensine II (ARA)) entraînent, par compensation, une élévation de l'activité rénine plasmatique (ARP), le traitement par l'aliskiren diminue l'ARP d'environ 50 à 80 % chez les patients hypertendus. Des réductions similaires ont été observées lorsque l'aliskiren a été associé à d'autres antihypertenseurs. Les conséquences cliniques des différences d'effet ne sont pas connues

Merci

RESPONSES TO ALISKIREN/HCTZ VERSUS AMLODIPINE ON PERIPHERAL AND CENTRAL BLOOD
PRESSURE IN AFRICAN AMERICAN PATIENTS WITH STAGE 2 HYPERTENSION

ACC Poster Contributions
Georgia World Congress Center, Hall B5
Tuesday, March 16, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Central Blood Pressure Drugs and Genes
Abstract Category: Hypertension
Presentation Number: 1240-103
Authors: Keith Ferdinand, James Pool, Richard Weitzman, Das Purkayastha, Raymond Townsend, Emory University, Decatur, GA


Background: In African American (AA) men, central BP may better reflect the levels of vascular burden than peripheral (brachial) BP. There is
a paucity of data on the efficacy of antihypertensive agents on central pressure in AA. This 8-week prospective, multicenter, randomized, doubleblind
study of AA patients with stage 2 (MSSBP ≥ 160 mmHg and < 200 mmHg) hypertension evaluated the brachial and central BP responses of
treatment with the single pill combination aliskiren/HCTZ (A/H) compared with amlodipine (AML).


Methods: Following a 1-4 week washout eligible patients ≥18 years (mean age= 52.6), received either A/H150/12.5 mg (n=166) or AML 5 mg
(n=166) for 1 week; force titrated to A/H 300/25 or AML 10 mg for 7 weeks. Primary efficacy was change from baseline in MSSBP at Week 8. A
substudy (n=52) evaluated treatment differences in central BP.
Results: At week 8, both treatments provided significant reductions in MSSBP from baseline [-28.6 ±17.95, -28.2 ± 13.17 mm Hg] in the A/H
and AML arms, with no significant differences between treatments. However, A/H significantly reduced (p <0.05) central SBP and increased pulse
pressure amplification ratio (brachial/central) vs AML (Table). Both treatments were well tolerated.


Conclusion: Despite similar reductions in peripheral SBP with the 2 treatments, reductions in central systolic pressure was significantly in favor of
A/H. Our findings suggest an important new treatment option since central pressure is considered an important risk factor in AA patients.

RESPONSES TO ALISKIREN/HCTZ VERSUS AMLODIPINE ON PERIPHERAL AND CENTRAL BLOOD
PRESSURE IN AFRICAN AMERICAN PATIENTS WITH STAGE 2 HYPERTENSION

ACC Poster Contributions
Georgia World Congress Center, Hall B5
Tuesday, March 16, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Central Blood Pressure Drugs and Genes
Abstract Category: Hypertension
Presentation Number: 1240-103
Authors: Keith Ferdinand, James Pool, Richard Weitzman, Das Purkayastha, Raymond Townsend, Emory University, Decatur, GA


Background: In African American (AA) men, central BP may better reflect the levels of vascular burden than peripheral (brachial) BP. There is
a paucity of data on the efficacy of antihypertensive agents on central pressure in AA. This 8-week prospective, multicenter, randomized, doubleblind
study of AA patients with stage 2 (MSSBP ≥ 160 mmHg and < 200 mmHg) hypertension evaluated the brachial and central BP responses of
treatment with the single pill combination aliskiren/HCTZ (A/H) compared with amlodipine (AML).


Methods: Following a 1-4 week washout eligible patients ≥18 years (mean age= 52.6), received either A/H150/12.5 mg (n=166) or AML 5 mg
(n=166) for 1 week; force titrated to A/H 300/25 or AML 10 mg for 7 weeks. Primary efficacy was change from baseline in MSSBP at Week 8. A
substudy (n=52) evaluated treatment differences in central BP.
Results: At week 8, both treatments provided significant reductions in MSSBP from baseline [-28.6 ±17.95, -28.2 ± 13.17 mm Hg] in the A/H
and AML arms, with no significant differences between treatments. However, A/H significantly reduced (p <0.05) central SBP and increased pulse
pressure amplification ratio (brachial/central) vs AML (Table). Both treatments were well tolerated.


Conclusion: Despite similar reductions in peripheral SBP with the 2 treatments, reductions in central systolic pressure was significantly in favor of
A/H. Our findings suggest an important new treatment option since central pressure is considered an important risk factor in AA patients.