Endocrine Hypertension Research Centre and Clinical Centre of Research Excellence in Cardiovascular Disease and Metabolic Disorders, University of Queensland School of Medicine, Greenslopes Princess Alexandra Hospitals, Brisbane, QLD, Australia;
Ther Clin Risk Manag. 2009 Jun;5(3):459-64. doi: 10.2147/tcrm.s5702. Epub 2009 Jun 22.
The renin-angiotensin-aldosterone system (RAAS) is a key mediator of blood pressure (BP) and volume regulation in both normotensive and hypertensive persons. Stimulation of RAAS also contributes to hypertension-related target organ damage. The renin-angiotensinogen reaction is the first and rate-limiting step in the generation of angiotensin II (Ang II) and has been a target of antihypertensive drug development for decades. Aliskiren is the first in a new class of orally effective direct renin inhibitors (DRIs) and is approved for the treatment of hypertension in humans. It effectively reduces BP in the general population of hypertensive patients and has a tolerability and safety profile similar to placebo. Aliskiren has favorable effects on vascular inflammation and remodeling, on neurohumoral mediators of various forms of cardiovascular disease, including heart failure, and on proteinuria in diabetic patients. Additional outcome trials are needed to establish the role of this novel class of antihypertensive medication in preventing cardiovascular disease morbidity and mortality.
肾素-血管紧张素-醛固酮系统（RAAS）是调节血压（BP）和容量的关键介质，在正常血压和高血压人群中均如此。RAAS 的刺激也有助于与高血压相关的靶器官损伤。肾素-血管紧张素原反应是生成血管紧张素 II（Ang II）的第一步和限速步骤，并且几十年来一直是降压药物开发的靶点。阿利克仑是新型口服有效直接肾素抑制剂（DRI）类药物中的第一种，已被批准用于人类高血压的治疗。它可有效降低一般高血压患者的血压，且耐受性和安全性与安慰剂相似。阿利克仑对血管炎症和重塑、心力衰竭等各种形式心血管疾病的神经激素介质以及糖尿病患者的蛋白尿均有有利影响。需要进一步的结局试验来确定这种新型降压药物在预防心血管疾病发病率和死亡率方面的作用。
