Pantzaris Nikolaos-Dimitrios, Karanikolas Evangelos, Tsiotsios Konstantinos, Velissaris Dimitrios
Medical School, University of Patras, Rio Achaia 26504, Greece.
Department of Medicine, Schools of Health Sciences, University of Athens75 Mikras Asias str., Athens 11527, Greece.
J Clin Med. 2017 Jun 9;6(6):61. doi: 10.3390/jcm6060061.
The renin-angiotensin-aldosterone system (RAAS) plays a key role in the pathophysiology of arterial hypertension as well as in more complex mechanisms of cardiovascular and renal diseases. RAAS-blocking agents like angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers, have long been key components in the treatment of essential hypertension, heart failure, diabetic nephropathy, and chronic kidney disease, showing benefits well beyond blood pressure reduction. Renin blockade as the first step of the RAAS cascade finally became possible in 2007 with the approval of aliskiren, the first orally active direct renin inhibitor available for clinical use and the newest antihypertensive agent on the market. In the last decade, many clinical trials and meta-analyses have been conducted concerning the efficacy and safety of aliskiren in comparison to other antihypertensive agents, as well as the efficacy and potential clinical use of various combinations. Large trials with cardiovascular and renal endpoints attempted to show potential benefits of aliskiren beyond blood pressure lowering, as well as morbidity and mortality outcomes in specific populations such as diabetics, heart failure patients, and post-myocardial infarction individuals. The purpose of this review is to present the currently available data regarding established and future potential clinical uses of aliskiren.
肾素-血管紧张素-醛固酮系统（RAAS）在动脉高血压的病理生理学以及心血管和肾脏疾病的更复杂机制中起着关键作用。像血管紧张素转换酶（ACE）抑制剂和血管紧张素II受体阻滞剂这样的RAAS阻断剂长期以来一直是原发性高血压、心力衰竭、糖尿病肾病和慢性肾病治疗的关键组成部分，其益处远不止于降低血压。随着阿利吉仑（aliskiren）在2007年获批，肾素阻断作为RAAS级联反应的第一步终于成为可能。阿利吉仑是首个可用于临床的口服活性直接肾素抑制剂，也是市场上最新的抗高血压药物。在过去十年中，已经开展了许多临床试验和荟萃分析，比较了阿利吉仑与其他抗高血压药物的疗效和安全性，以及各种联合用药的疗效和潜在临床用途。以心血管和肾脏终点为指标的大型试验试图证明阿利吉仑除了降低血压之外的潜在益处，以及在特定人群（如糖尿病患者、心力衰竭患者和心肌梗死后个体）中的发病率和死亡率结果。本综述的目的是介绍目前关于阿利吉仑既定和未来潜在临床用途的可用数据。
