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Comparative efficacy of aliskiren monotherapy and ramipril monotherapy in patients with stage 2 systolic hypertension: subgroup analysis of a double-blind, active comparator trial.
Cardiovasc Ther. 2010 Dec; 28(6):344-9.CT

Abstract

Aliskiren is the first direct renin inhibitor approved for the treatment of hypertension. Blood pressure (BP) control in stage 2 hypertension with aliskiren monotherapy has not been reported. This was a post hoc analysis of the subgroup of patients with stage 2 systolic hypertension (baseline mean sitting systolic BP [msSBP]≥160 mmHg) who completed the 12-week monotherapy phase of a 6-month, double-blind, randomized study. A total of 175 patients were randomized to aliskiren 150 mg (n = 88) or ramipril 5 mg (n = 87) with optional up-titration to aliskiren 300 mg or ramipril 10 mg, respectively, at weeks 6 and 12. In the subgroup of patients with stage 2 systolic hypertension, aliskiren lowered msSBP and mean sitting diastolic BP (msDBP) by 22.3/12.7 mmHg from baseline to week 12; compared with a reduction of 18.1/10.2 mmHg with ramipril. The maximum BP reductions achieved with aliskiren were 60.0/34.0 mmHg (from a baseline of 172.7/107.3 mmHg). Aliskiren was noninferior (P < 0.0001) to ramipril for SBP reduction with nonsignificant superiority (P = 0.052), and superior (P = 0.043) to ramipril for DBP reduction. The proportion of patients who achieved BP control (<140/90 mmHg) after 12 weeks of monotherapy was larger with aliskiren (34/88, 38.6%) than with ramipril (22/87, 25.3%; P = 0.038). In this post hoc analysis, 12 weeks of monotherapy with aliskiren 150-300 mg provided effective mean BP reductions (22/13 mmHg) and was superior to ramipril 5-10 mg in controlling BP in patients with stage 2 systolic hypertension.

Authors+Show Affiliations

University of Iceland, Reykjavik, Iceland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20406241

Citation

Andersen, Karl, et al. "Comparative Efficacy of Aliskiren Monotherapy and Ramipril Monotherapy in Patients With Stage 2 Systolic Hypertension: Subgroup Analysis of a Double-blind, Active Comparator Trial." Cardiovascular Therapeutics, vol. 28, no. 6, 2010, pp. 344-9.
Andersen K, Weinberger MH, Egan B, et al. Comparative efficacy of aliskiren monotherapy and ramipril monotherapy in patients with stage 2 systolic hypertension: subgroup analysis of a double-blind, active comparator trial. Cardiovasc Ther. 2010;28(6):344-9.
Andersen, K., Weinberger, M. H., Egan, B., Constance, C. M., Wright, M., Lukashevich, V., & Keefe, D. L. (2010). Comparative efficacy of aliskiren monotherapy and ramipril monotherapy in patients with stage 2 systolic hypertension: subgroup analysis of a double-blind, active comparator trial. Cardiovascular Therapeutics, 28(6), 344-9. https://doi.org/10.1111/j.1755-5922.2010.00148.x
Andersen K, et al. Comparative Efficacy of Aliskiren Monotherapy and Ramipril Monotherapy in Patients With Stage 2 Systolic Hypertension: Subgroup Analysis of a Double-blind, Active Comparator Trial. Cardiovasc Ther. 2010;28(6):344-9. PubMed PMID: 20406241.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative efficacy of aliskiren monotherapy and ramipril monotherapy in patients with stage 2 systolic hypertension: subgroup analysis of a double-blind, active comparator trial. AU - Andersen,Karl, AU - Weinberger,Myron H, AU - Egan,Brent, AU - Constance,Christian M, AU - Wright,Melanie, AU - Lukashevich,Valentina, AU - Keefe,Deborah L, PY - 2010/4/22/entrez PY - 2010/4/22/pubmed PY - 2011/2/22/medline SP - 344 EP - 9 JF - Cardiovascular therapeutics JO - Cardiovasc Ther VL - 28 IS - 6 N2 - Aliskiren is the first direct renin inhibitor approved for the treatment of hypertension. Blood pressure (BP) control in stage 2 hypertension with aliskiren monotherapy has not been reported. This was a post hoc analysis of the subgroup of patients with stage 2 systolic hypertension (baseline mean sitting systolic BP [msSBP]≥160 mmHg) who completed the 12-week monotherapy phase of a 6-month, double-blind, randomized study. A total of 175 patients were randomized to aliskiren 150 mg (n = 88) or ramipril 5 mg (n = 87) with optional up-titration to aliskiren 300 mg or ramipril 10 mg, respectively, at weeks 6 and 12. In the subgroup of patients with stage 2 systolic hypertension, aliskiren lowered msSBP and mean sitting diastolic BP (msDBP) by 22.3/12.7 mmHg from baseline to week 12; compared with a reduction of 18.1/10.2 mmHg with ramipril. The maximum BP reductions achieved with aliskiren were 60.0/34.0 mmHg (from a baseline of 172.7/107.3 mmHg). Aliskiren was noninferior (P < 0.0001) to ramipril for SBP reduction with nonsignificant superiority (P = 0.052), and superior (P = 0.043) to ramipril for DBP reduction. The proportion of patients who achieved BP control (<140/90 mmHg) after 12 weeks of monotherapy was larger with aliskiren (34/88, 38.6%) than with ramipril (22/87, 25.3%; P = 0.038). In this post hoc analysis, 12 weeks of monotherapy with aliskiren 150-300 mg provided effective mean BP reductions (22/13 mmHg) and was superior to ramipril 5-10 mg in controlling BP in patients with stage 2 systolic hypertension. SN - 1755-5922 UR - https://www.unboundmedicine.com/medline/citation/20406241/Comparative_efficacy_of_aliskiren_monotherapy_and_ramipril_monotherapy_in_patients_with_stage_2_systolic_hypertension:_subgroup_analysis_of_a_double_blind_active_comparator_trial_ L2 - https://doi.org/10.1111/j.1755-5922.2010.00148.x DB - PRIME DP - Unbound Medicine ER -