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https://www.readbyqxmd.com/read/28537000/advances-in-clinical-cardiology-2016-a-summary-of-the-key-clinical-trials
#1
REVIEW
Alastair Gray, Conor McQuillan, Ian B A Menown
INTRODUCTION: The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. METHODS: The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA)...
May 23, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28509129/successful-long-term-effects-of-direct-renin-inhibitor-aliskiren-in-a-patient-with-atherosclerotic-renovascular-hypertension
#2
Norihiko Morisawa, Naoki Sugano, Takafumi Yamakawa, Satoru Kuriyama, Takashi Yokoo
A 64-year-old man visited our hospital with complaints of misty vision and ophthalmalgia. On admission, his blood pressure (BP) was high at 220/135 mmHg with no past history of hypertension, and he had choked discs. He was tentatively diagnosed as having idiopathic intracranial hypertension, and was later found to have atherosclerotic unilateral renovascular hypertension (RVH) based upon the extremely high plasma renin activity together with the radiological image tests. On day 3, combined antihypertensive therapies consisting of oral angiotensin II receptor blocker (ARB) and Ca channel blocker (CCB) along with intravenous CCB induced an abrupt BP lowering which led to deterioration of his renal function, progressing into acute kidney injury (AKI)...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28498232/antihypertensive-drugs-aliskiren-nebivolol-and-olmesartan-reduce-hypertension-by-reducing-endothelial-microparticle-and-regulating-angiogenesis
#3
Moon Jain, Vivek Bhosale, Dipti Tripathi, Himalaya Singh, Niharika Pal, Kashif Hanif, Kumaravelu Jagavelu
The accelerated generation of endothelial microparticles (EMP) and impaired angiogenesis are the markers of vascular pathology during various cardiovascular and inflammatory conditions including hypertension. Since, studies comparing the effects of antihypertensive agents on these two parameters are limited; the present study was designed to compare the effects of three antihypertensive agents: aliskiren, nebivolol, and olmesartan, on the EMP generation and angiogenesis. Changes in the hemodynamic parameters and serum EMP count were determined post 3 weeks of the drug treatments [aliskiren (30 mg/kg), nebivolol (10 mg/kg), or olmesartan (5 mg/kg) per orally] in L-NAME induced rat model of hypertension...
May 9, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/28464775/renoprotection-by-direct-renin-inhibition-a-systematic-review-and-meta-analysis
#4
Nikolaos Louvis, James Coulson
Even mild abnormalities of the renal structure or function can increase the risk of mortality and complications in other organs. Therefore, safe and effective treatments are necessary in order to influence the progression of renal disease. We used 2 methods to assess the renoprotective effects of aliskiren: 1) a statistical analysis of clinical trials that investigated aliskiren-induced renoprotection, in terms of changes in serum creatinine concentration (sCr) or estimated glomerular filtration rate (eGFR), and, 2) clinical trials that investigated the renoprotective effects of aliskiren with respect to changes in albuminuria or proteinuria...
May 1, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28455996/aliskiren-reduces-albuminuria-after-kidney-transplantation
#5
Leszek Tylicki, Alicja M Debska-Slizien, Slawomir Lizakowski, Milena Przybylska, Zbigniew Heleniak, Marcin Renke, Andrzej L Chamienia, Bogdan Biedunkiewicz, Przemyslaw Rutkowski, Sylwia Małgorzewicz, Boleslaw Rutkowski
BACKGROUND: The renoprotective effects of the direct renin inhibitor, aliskiren, in renal transplant recipients have been supposed, but not finally proven. We performed an exploratory double-blind, losartan controlled, cross-over study to evaluate the influence of aliskiren, direct renin inhibitor, on albuminuria and other surrogate markers of kidney injury in patients after renal transplantation. The safety of this therapy was also evaluated. METHOD: 16 of 18 patients (12 M, 4 F), 48...
April 28, 2017: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/28449154/dual-raas-blockade-with-aliskiren-in-patients-with-severely-impaired-chronic-kidney-disease
#6
Franz Maximilian Rasche, Claudia Joel, Thomas Ebert, Thomas Frese, Filip Barinka, Volker Busch, Wilma Gertrud Rasche, Tom H Lindner, Jochen Schneider, Stephan Schiekofer
Dual renin-angiotensin-aldosterone blockade (dRAASb) is purposed in the prevention of the cardiorenal syndrome (CRS). However, all attempts with dRAASb even in patients with moderate impaired chronic kidney disease (CKD) were terminated due to the typical severe adverse events (SAE), e. g., hyperkalemia and rise of serum creatinine. The aim of our study with the direct renin inhibitor aliskiren was to evaluate the effect of dRAASb with a washout phase in patients with severely advanced CKD. We have studied 45 patients (G3b to 4, A2 and >A3; median glomerular filtration rate (GFR) CKD-EPI 31 (23-40) ml/min per 1...
April 27, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28409014/comparable-effect-of-aliskiren-or-a-diuretic-added-on-an-angiotensin-ii-receptor-blocker-on-augmentation-index-in-hypertension-a-multicentre-prospective-randomised-study
#7
Toru Miyoshi, Takashi Murakami, Satoru Sakuragi, Masayuki Doi, Seiji Nanba, Atsushi Mima, Youkou Tominaga, Takafumi Oka, Yutaka Kajikawa, Kazufumi Nakamura, Hiroshi Ito
BACKGROUND: The effects of antihypertensive drug combination therapy on central blood pressure (BP) and augmentation index (AI) have not been fully elucidated. We investigated the effects of the direct renin inhibitor, aliskiren, or a diuretic added to an angiotensin II receptor blocker on AI in patients with essential hypertension. METHODS: A 24-week, prospective, multicentre, randomised, open-label study enrolled 103 patients already treated with valsartan. Participants were randomly allocated to receive either valsartan with aliskiren (V+A), or valsartan with trichlormethiazide (V+T)...
2017: Open Heart
https://www.readbyqxmd.com/read/28379619/blood-pressure-lowering-efficacy-of-renin-inhibitors-for-primary-hypertension
#8
REVIEW
Vijaya M Musini, Kendra Ak Lawrence, Patricia M Fortin, Ken Bassett, James M Wright
BACKGROUND: Hypertension is a chronic condition associated with an increased risk of mortality and morbidity. Renin is the enzyme responsible for converting angiotensinogen to angiotensin I, which is then converted to angiotensin II. Renin inhibitors are a new class of drugs that decrease blood pressure (BP) by preventing the formation of both angiotensin I and angiotensin II. OBJECTIVES: To quantify the dose-related BP lowering efficacy of renin inhibitors compared to placebo in the treatment of primary hypertension...
April 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28356668/targeting-renin-angiotensin-system-in-malignant-hypertension-in-atypical-hemolytic-uremic-syndrome
#9
V Raghunathan, S K Sethi, M A Dragon-Durey, M Dhaliwal, R Raina, P Jha, S B Bansal, V Kher
Hypertension is common in hemolytic uremic syndrome (HUS) and often difficult to control. Local renin-angiotensin activation is believed to be an important part of thrombotic microangiopathy, leading to a vicious cycle of progressive renal injury and intractable hypertension. This has been demonstrated in vitro via enhanced tissue factor expression on glomerular endothelial cells which is enhanced by angiotensin II. We report two pediatric cases of atypical HUS with severe refractory malignant hypertension, in which we targeted the renin-angiotensin system by using intravenous (IV) enalaprilat, oral aliskiren, and oral enalapril with quick and dramatic response of blood pressure...
March 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28228402/aliskiren-increases-aquaporin-2-expression-and-attenuates-lithium-induced-nephrogenic-diabetes-insipidus
#10
Yu Lin, Tiezheng Zhang, Pinning Feng, Miaojuan Qiu, Qiaojuan Liu, Suchun Li, Peili Zheng, Yonglun Kong, Moshe Levi, Chunling Li, Weidong Wang
The direct renin inhibitor aliskiren has been shown to retain and persist in medullary collecting ducts even after treatment was discontinued, suggesting a new mechanism of action for this drug. The purpose of the present study was to investigate whether aliskiren regulates renal aquaporin expression in the collecting ducts and improves urinary concentrating defect induced by lithium in mice. The mice were either fed with normal chow or LiCl diet (40mM/kg dry food/day for 4 days and 20mM/kg dry food/day for last 3 days) for seven days...
February 22, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28199630/end-of-the-road-for-aliskiren-in-heart-failure
#11
Andros Tofield
No abstract text is available yet for this article.
February 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28118402/effects-of-direct-renin-blockade-on-renal-systemic-hemodynamics-and-on-raas-activity-in-weight-excess-and-hypertension-a-randomized-clinical-trial
#12
A J Kwakernaak, L C Roksnoer, H J Lambers Heerspink, I van den Berg-Garrelds, G A Lochorn, J H van Embden Andres, M A Klijn, H Kobori, A H J Danser, G D Laverman, G J Navis
AIM: The combination of weight excess and hypertension significantly contributes to cardiovascular risk and progressive kidney damage. An unfavorable renal hemodynamic profile is thought to contribute to this increased risk and may be ameliorated by direct renin inhibition (DRI). The aim of this trial was to assess the effect of DRI on renal and systemic hemodynamics and on RAAS activity, in men with weight excess and hypertension. METHODS: A randomized, double-blind, cross-over clinical trial to determine the effect of DRI (aliskiren 300 mg/day), with angiotensin converting enzyme inhibition (ACEi; ramipril 10 mg/day) as a positive control, on renal and systemic hemodynamics, and on RAAS activity (n = 15)...
2017: PloS One
https://www.readbyqxmd.com/read/28107310/the-renin-inhibitor-aliskiren-protects-rat-lungs-from-the-histopathologic-effects-of-fat-embolism
#13
Amanda N Fletcher, Agostino Molteni, Rakesh Ponnapureddy, Chirag Patel, Mark Pluym, Alan M Poisner
BACKGROUND: Fat embolism (FE) and the consequent FE syndrome occurring after trauma or surgery can lead to serious pulmonary injury, including ARDS and death. Current treatment of FE syndrome is limited to supportive therapy. We have shown in a rat model that the renin angiotensin system plays a significant role in the pathophysiology of FE because drugs interfering with the renin angiotensin system, captopril and losartan reduce the histopathologic pulmonary damage. The purpose of the current study was to determine if inhibition of renin by aliskiren, an FDA-approved drug for treating hypertension, would produce effective protection in the same model...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28096205/effect-of-prepublication-results-on-trends-in-prescribing-of-antihypertensive-medication-impact-of-the-altitude-aliskiren-trial-in-type-2-diabetes-using-cardio-renal-disease-endpoints-trial-on-aliskiren-prescribing
#14
Sahar S Othman, Peter C Austin, Jack V Tu, Douglas S Lee
No abstract text is available yet for this article.
January 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28040266/angiotensin-ii-at1-receptor-signaling-is-necessary-for-cyclooxygenase-2-dependent-postnatal-nephron-generation
#15
Stefanie Frölich, Patrick Slattery, Dominique Thomas, Itamar Goren, Nerea Ferreiros, Boye L Jensen, Rolf M Nüsing
Deletion of cyclooxygenase-2 (COX-2) causes impairment of postnatal kidney development. Here we tested whether the renin angiotensin system contributes to COX-2-dependent nephrogenesis in mice after birth and whether a rescue of impaired renal development and function in COX-2(-/-) mice was achievable. Plasma renin concentration in mouse pups showed a birth peak and a second peak around day P8 during the first 10 days post birth. Administration of the angiotensin II receptor AT1 antagonist telmisartan from day P1 to P3 did not result in cortical damage...
December 28, 2016: Kidney International
https://www.readbyqxmd.com/read/28002889/variability-in-response-to-albuminuria-lowering-drugs-true-or-random
#16
Sergei I Petrykiv, Dick de Zeeuw, Frederik Persson, Peter Rossing, Ron T Gansevoort, Gozewijn D Laverman, Hiddo J L Heerspink
AIMS: Albuminuria-lowering drugs have shown different effect size in different individuals. Since urine albumin levels are known to vary considerably from day-to-day, we questioned whether the between-individual variability in albuminuria response after therapy initiation reflects a random variability or a true response variation to treatment. In addition, we questioned whether the response variability is drug dependent. METHODS: To determine whether the response to treatment is random or a true drug response, we correlated in six clinical trials the change in albuminuria during placebo or active treatment (on-treatment) with the change in albuminuria during wash-out (off-treatment)...
June 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27936941/comparison-of-direct-renin-inhibitor-and-angiotensin-ii-receptor-blocker-on-clinic-and-ambulatory-blood-pressure-profiles-in-hypertension-with-chronic-kidney-disease
#17
RANDOMIZED CONTROLLED TRIAL
Kazushi Uneda, Kouichi Tamura, Hiromichi Wakui, Kengo Azushima, Sona Haku, Ryu Kobayashi, Kohji Ohki, Kotaro Haruhara, Sho Kinguchi, Masato Ohsawa, Tetsuya Fujikawa, Satoshi Umemura
We compared the therapeutic effects of aliskiren (direct renin inhibitor (DRI) group) with angiotensin II (Ang II) type 1 receptor blockers (ARBs) (ARB group) on clinic blood pressure (BP) and ambulatory BP in 36 hypertensive chronic kidney disease (CKD) patients. The baseline clinic BP levels and the after-treatment/baseline (A/B) ratios of clinic BP levels, estimated after 24-week treatment period, were similar in DRI group (n = 18) and ARB group (n = 18). With respect to the effects on ambulatory BP, the A/B ratios of the daytime and nighttime systolic BP in DRI group were significantly higher than those in ARB group...
2016: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/27889788/inhibition-of-angiotensin-ii-production-increases-susceptibility-to-acute-ischemia-reperfusion-arrhythmia
#18
Eylem Taskin, Kadir Ali Tuncer, Celal Guven, Salih Tunc Kaya, Nurcan Dursun
BACKGROUND Myocardial ischemia and reperfusion lead to impairment of electrolyte balance and, eventually, lethal arrhythmias. The aim of this study was to investigate the effects of pharmacological inhibition of angiotensin-II (Ang-II) production on heart tissue with ischemia-reperfusion damage, arrhythmia, and oxidative stress. MATERIAL AND METHODS Rats were divided into 4 groups: only ischemia/reperfusion (MI/R), captopril (CAP), aliskiren (AL), and CAP+AL. The drugs were given by gavage 30 min before anesthesia...
November 27, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27859873/impact-of-an-intervention-on-the-prescription-of-aliskiren-after-new-evidence-on-safety-reported
#19
Isabel Rosich Martí, Alejandro Allepuz, Gemma Rodriguez Palomar, Francesca Ortin Font, Maria Soler Cera
PURPOSE: The purpose of the study is to analyze the impact of an intervention to disseminate safety alerts on the utilization of Aliskiren added to angiotensin converting enzyme inhibitor (ACEI) or an angiotensin-receptor blocker (ARB). METHODS: Quasi-experimental design (non-randomized intervention) comparing the utilization of Aliskiren + ACEI or ARB in a primary care area-intervention (PCA-I) with a primary care area-control (PCA-C) following a safety alert...
November 16, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27809355/aliskiren-protects-against-myocardial-ischemia-reperfusion-injury-via-an-endothelial-nitric-oxide-synthase-dependent-manner
#20
Yu Chen, Guoliang Meng, Wenli Bai, Yan Ma, Liping Xie, Naila Altaf, Yanning Qian, Yi Han, Yong Ji
Aliskiren, a direct renin inhibitor, was shown potent ability to attenuate hypertension. Our previous research has found that aliskiren protected against myocardial ischemia-reperfusion (I/R) injury and enhanced phosphorylation of endothelial nitric oxide synthase (eNOS) in spontaneously hypertensive rats. However, whether the cardioprotective effect of aliskiren against myocardial I/R injury was eNOS-dependent is unknown. In the present study, 12-week-old male eNOS knockout (eNOS(-/-) ) and wild-type C57BL/6J mice (WT) were orally administrated with the dose of 50 mg/kg/day of aliskiren...
November 3, 2016: Clinical and Experimental Pharmacology & Physiology
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