"Aliskiren and valsartan are both effective antihypertensives, but they function very differently," said Suzanne Oparil, MD, professor of medicine, physiology and biophysics, University of Alabama School of Medicine, Birmingham, Alabama, United States. "Marrying these 2 treatment options will give physicians a more effective way to control high blood pressure in their patients."

Dr. Oparil said that aliskiren -- the first of a new class of high blood pressure drugs called direct renin inhibitors -- strikes at the top of the cascade of molecular events that leads to the release of angiotensin, which is implicated in high blood pressure and heart disease. On the other hand, valsartan inhibits the renin system further down the cascade.

Together, "we believe the drugs can control that nasty little peptide, angiotensin, from damaging organs," she said in her presentation on March 26^th.

Dr. Oparil and colleagues enrolled 1,797 patients to 1 of 4 once-daily treatments for 4 weeks: combination of aliskiren 150 mg and valsartan 160 mg; aliskiren 150 mg alone; valsartan 160 mg alone; placebo. After 4 weeks, the doses were doubled for another 4 weeks.

Blood pressure was checked at baseline and again at 4 and 8 weeks. Blood pressure control was defined as 140/90 mm Hg

Dr. Oparil said that 49.3% of patients taking the combination of aliskiren and valsartan achieved blood pressure control compared with 37.4% with aliskiren alone, 33.8% with valsartan alone, and 16.5% with placebo.

There were no serious adverse effects in any of the dosage groups or in the placebo group, which indicates that the combination therapy was safe and tolerable for all participants.


[Presentation title: The Direct Renin Inhibitor Aliskiren in Combination With the Angiotensin Receptor Blocker Valsartan Provides Additional Blood Pressure-Lowering Effects Compared With Either Agent Alone in Patients With Hypertension. Abstract 405-12]

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