Renin inhibition for hypertension: selecting the right role for a new class of drug.

摘要

With the arrival of a new class of drugs for the management of hypertension comes the need to define its role. Aliskiren, an orally administered direct renin inhibitor, has been approved by the US Food and Drug Administration for the treatment of hypertension. Currently, the recommendation for choice of agent in the treatment of uncomplicated hypertension is a thiazide diuretic, and for patients with diabetic nephropathy, heart failure, or coronary artery disease, an angiotensin-converting enzyme inhibitor. Patients for whom an angiotensin-converting enzyme inhibitor is indicated who are intolerant as a result of side effects should take an angiotensin receptor blocker. A new class of medicines that specifically inhibits renin is an exciting addition to the armamentarium in the treatment of hypertension. This article explores the role of aliskiren in treating hypertension as well as its side effects and appropriate dosing.