Department of Cardiology, The Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Shaanxi, PR China.
Am J Hypertens. 2011 May;24(5):613-21. doi: 10.1038/ajh.2011.3. Epub 2011 Feb 3.
Aliskiren, a newly discovered renin inhibitor, blocks the renin-angiotensin system (RAS) from the top of the enzyme cascade and therefore, might provide comparable or even superior clinical efficacy of blood pressure (BP) control than angiotensin receptor blockers (ARBs). With this meta-analysis, we aimed to compare the efficacy and tolerability of aliskiren and ARBs in the treatment of hypertension in the short-term treatment period.
Reports of randomized controlled trials (RCTs) comparing aliskiren and ARBs in patients with hypertension were selected by a search of the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE. The main outcome measures were reduction in diastolic BP (DBP) and systolic BP (SBP) and rates of therapeutic response and BP control. We also compared the tolerability of aliskiren and ARBs. Revman v5.0 was used to obtain the pooled estimates.
We analyzed data from 10 reports of trials involving 3,732 participants. DBP and SBP reduction did not differ between aliskiren and ARBs (weighted mean difference (WMD), -0.18; 95% confidence interval (CI), -1.07 to 0.71, and WMD, 0.15; 95% CI, -1.38 to 1.69, respectively). Aliskiren and ARB treatment did not differ in rates of BP control or therapeutic response. Moreover, aliskiren and ARB treatment led to a similar number of adverse events, severe adverse events, and withdrawal due to adverse events.
Aliskiren is as effective as ARBs (losartan, valsartan, and irbesartan) in controlling BP and does not differ from ARBs in risk of adverse events.
阿利吉仑是一种新发现的肾素抑制剂，可从酶级联的顶端阻断肾素-血管紧张素系统（RAS），因此，其控制血压（BP）的临床疗效可能与血管紧张素受体阻滞剂（ARBs）相当，甚至更优。通过本次荟萃分析，我们旨在比较短期治疗期间阿利吉仑和 ARBs 在高血压治疗中的疗效和耐受性。
通过对 Cochrane 对照试验中心注册库、MEDLINE 和 EMBASE 的检索，选择了比较高血压患者中阿利吉仑和 ARBs 的随机对照试验（RCT）报告。主要结局指标为舒张压（DBP）和收缩压（SBP）的降低率以及治疗反应率和 BP 控制率。我们还比较了阿利吉仑和 ARBs 的耐受性。Revman v5.0 用于获取汇总估计值。
我们分析了来自 10 项试验报告的数据，涉及 3732 名参与者。阿利吉仑和 ARBs 的 DBP 和 SBP 降低没有差异（加权均数差（WMD），-0.18；95%置信区间（CI），-1.07 至 0.71，和 WMD，0.15；95%CI，-1.38 至 1.69）。阿利吉仑和 ARB 治疗在 BP 控制率或治疗反应率方面没有差异。此外，阿利吉仑和 ARB 治疗导致不良反应、严重不良反应和因不良反应退出的数量相似。
阿利吉仑在控制血压方面与 ARBs（氯沙坦、缬沙坦和厄贝沙坦）同样有效，且在不良反应风险方面与 ARBs 无差异。
