Comparative Efficacy and Safety of Aliskiren and Irbesartan in Patients with Hypertension and Metabolic Syndrome
Journal of Human Hypertension (2011) 25, 186–195 & 2011 Macmillan Publishers Limited All rights reserved 0950-9240/11 www.nature.com/jhh ORIGINAL ARTICLE Comparative efficacy and safety of aliskiren and irbesartan in patients with hypertension and metabolic syndrome W Krone1, M Hanefeld2, H-F Meyer3, T Jung4, M Bartlett5, C-M Yeh6, I Rajman5, MF Prescott6 and WP Dole7 1Klinik II und Poliklinik fu¨r Innere Medizin, Zentrum fu¨r Molekulare Medizin der Universita¨tzuKo¨ln, Cologne, Germany; 2Centre for Clinical Studies, GWT-TUD GmbH, Dresden, Germany; 3Facharzt fu¨r Allgemeinmedizin, Marl, Germany; 4Facharzt fu¨r Allgemeinmedizin, Deggingen, Germany; 5Novartis Institutes for Biomedical Research, Basel, Switzerland; 6Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA and 7Novartis Institutes for Biomedical Research Inc., Cambridge, MA, USA Metabolic syndrome, a cluster of risk factors that than the 5.8/2.8 mm Hg reduction observed in patients increase the risk of cardiovascular morbidity and mor- treated with irbesartan 300 mg. A significantly greater tality, is common in patients with hypertension. Chronic proportion of patients treated with aliskiren achieved BP renin–angiotensin–aldosterone system (RAAS) activa- control to o135/85 mm Hg (29.2 vs 16.7% with irbesartan; tion, shown by elevated plasma renin activity (PRA), is P ¼ 0.019). Aliskiren treatment led to a 60% decrease in implicated in many of the features of metabolic syn- PRA from baseline, whereas irbesartan increased PRA drome. The direct renin inhibitor aliskiren may be of by 99% (both Po0.001). Aliskiren and irbesartan had benefit in this patient group as aliskiren targets the similar effects on glucose and lipid profiles and on a RAAS at the rate-limiting step.
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