Effects of Aliskiren Monotherapy versus Amlodipine Monotherapy in Hypertensive Patients with Obesity or Type 2 Diabetes Mellitus.
Journal
Kidney & blood pressure research
ISSN: 1423-0143
Titre abrégé: Kidney Blood Press Res
Pays: Switzerland
ID NLM: 9610505
Informations de publication
Date de publication:
20 Oct 2023
20 Oct 2023
Historique:
received:
13
11
2022
accepted:
22
08
2023
medline:
23
10
2023
pubmed:
23
10
2023
entrez:
22
10
2023
Statut:
aheadofprint
Résumé
Renin-angiotensin system inhibitors have been reported to exert protective effects against organ damage and failure; however, the impact of direct renin inhibitor as monotherapy has not been assessed. Here we investigated the effects of 24-week monotherapy with aliskiren compared to amlodipine in hypertensive patients with type 2 diabetes or obesity. In this randomized intervention study, 62 adult hypertensive patients with visceral obesity (defined as a body mass index [BMI] greater than 25 kg/m2 and visceral adipose tissue area [VFA] greater than 100 cm2) or type 2 diabetes mellitus (age 57 ± 13, 65% men, BMI 28.8 ± 4.8 kg/m2, VFA 134.8 ± 47.0 cm2, blood pressure 141 ± 16/86 ± 13 mmHg) were randomized to receive 24-week treatment with aliskiren (max. 300 mg) or amlodipine (max. 10 mg). The primary outcome was the change in VFA at 24 weeks post-treatment. Change in VFA did not differ significantly from baseline in either group. Systolic blood pressure significantly decreased at 12 weeks (-10 mmHg, P = 0.001) and 24 weeks (-10 mmHg, P = 0.001) in the amlodipine group and at 24 weeks (-11 mmHg, P = 0.001) in the aliskiren group. Diastolic blood pressure significantly decreased at 24 weeks (-6 mmHg, P = 0.009) only in the amlodipine group. Although the estimated glomerular filtration rates did not significantly change in either group, the logarithm of urinary albumin excretion significantly decreased at 24 weeks only in the aliskiren group (-0.60, P < 0.001). The 24-week changes in the urinary albumin excretion significantly correlated with the changes in the plasma renin activity in the aliskiren group (r = 0.51, P = 0.008). Aliskiren monotherapy did not show any superiority to amlodipine monotherapy on VFA, estimated glomerular filtration rates, or urinary albumin excretion in obese or type 2 diabetic hypertensive patients.
Identifiants
pubmed: 37866351
pii: 000533834
doi: 10.1159/000533834
pmc: PMC10652658
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
The Author(s). Published by S. Karger AG, Basel.
Références
Eur Heart J. 2011 Sep;32(17):2135-42
pubmed: 21415069
Semin Nephrol. 2007 Mar;27(2):144-52
pubmed: 17418683
Front Endocrinol (Lausanne). 2021 Jun 02;12:682726
pubmed: 34149621
Hypertens Res. 2018 Jun;41(6):435-443
pubmed: 29618841
N Engl J Med. 2008 Jun 5;358(23):2433-46
pubmed: 18525041
Hypertens Res. 2009 Jan;32(1):3-107
pubmed: 19300436
Hypertens Res. 2012 Aug;35(8):874-81
pubmed: 22592665
Hypertens Res. 2022 Jun;45(6):1072-1075
pubmed: 35361929
Hypertension. 2019 Aug;74(2):331-340
pubmed: 31230539
J Hum Hypertens. 2010 Sep;24(9):600-8
pubmed: 20033075
J Hum Hypertens. 2019 Nov;33(11):795-806
pubmed: 30631130
Circulation. 2008 Jun 24;117(25):3199-205
pubmed: 18559696
Nihon Jinzo Gakkai Shi. 2012;54(8):1034-191
pubmed: 23387281
Drugs. 2019 Mar;79(4):365-379
pubmed: 30758803
J Hum Hypertens. 2002 Feb;16(2):97-103
pubmed: 11850766
Asia Pac J Clin Nutr. 2007;16 Suppl 1:359-67
pubmed: 17392133
PLoS Med. 2012 Jan;9(1):e1001160
pubmed: 22291576
Clin Hypertens. 2017 Oct 24;23:20
pubmed: 29085669
Hypertens Res. 2012 Jul;35(7):756-60
pubmed: 22378472
Hypertension. 2008 Jul;52(1):130-6
pubmed: 18490518
N Engl J Med. 2001 Sep 20;345(12):861-9
pubmed: 11565518
Eur Heart J. 2012 Jun;33(12):1530-8
pubmed: 22450428
J Hypertens. 2007 Apr;25(4):841-8
pubmed: 17351377
J Hum Hypertens. 2013 May;27(5):321-7
pubmed: 23076450
BMC Cardiovasc Disord. 2020 Apr 17;20(1):179
pubmed: 32303191
Intern Med. 2017;56(6):587-596
pubmed: 28321055
Am J Physiol Regul Integr Comp Physiol. 2004 Oct;287(4):R943-9
pubmed: 15191907
Am J Kidney Dis. 2009 Jun;53(6):982-92
pubmed: 19339088
N Engl J Med. 2012 Dec 6;367(23):2204-13
pubmed: 23121378
Hypertens Res. 2019 Sep;42(9):1235-1481
pubmed: 31375757
Diabetes Care. 2005 Feb;28(2):451-3
pubmed: 15677816
J Pharmacol Sci. 2010;113(4):296-300
pubmed: 20675959
Front Pharmacol. 2020 Aug 10;11:1157
pubmed: 32848766
Hypertension. 2003 Dec;42(6):1137-43
pubmed: 14597641