Abstract
Hypertension is one of the most common causes of death across the globe. Many trials and drugs have been used for controlling the debilitating effects of hypertension. One such new class of drug is direct renin inhibitors (DRI), e.g., aliskiren, which block the renin-angiotensin system (RAS). It blocks the very first step in the RAS system. Multiple trials have been carried out debating the outcome of monotherapy and combination therapy with other classes of hypertensive drugs. Focus on compliance, adverse effects, and the cost have also been in the news. Extensive studies are still needed to justify the clinical use of a DRI in the effective treatment of hypertension.
Highlights
BackgroundHypertension is one among the leading factors that contribute towards the cardiovascular disease reported worldwide
It is defined as a condition in which the mean systolic blood pressure (SBP) is ≥ 140 mm of Hg and a mean diastolic blood pressure is ≥ 90 mm of Hg
About 30% of hypertension cases can be attributed to increased salt intake and 20% to low dietary potassium owning to the lack of fruit and vegetables in the diet
Summary
Hypertension is one among the leading factors that contribute towards the cardiovascular disease reported worldwide. ARBs act on AT1 receptors, which interrupt the negative feedback control of renin release and cause an increase in plasma renin activity, along with an increase in angiotensin I and angiotensin II This leads to inflammation, fibrosis, and oxidant injury of the organs, including the kidneys [32,33]. The study concluded that aliskiren does have an additional renoprotective effect with mild lowering of blood pressure properties when used in combination to ARBs [36]. Another similar study conducted to learn about the effectiveness of dual therapy over monotherapy in the management of the cardiovascular and renal system was stopped due to adverse effects, including hypotension, hyperkalemia, and acute renal injury, with the use of ACEI and ARB [37].
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