Antihypertensive efficacy of FK906, a novel human renin inhibitor.

The antihypertensive efficacy of a newly developed orally active human renin inhibitor (FK906) was evaluated in 14 patients with essential hypertension aged 40 to 83 years (mean, 64 years). After a 1-week placebo run-in period, 25 mg of FK906 was given twice daily; this was increased up to 100 mg twice daily until sufficient blood pressure reduction was obtained. No adverse effects were observed in any patients. Supine blood pressure was decreased from 169 +/- 3/97 +/- 1 mmHg to 153 +/- 5/87 +/- 3 mmHg at 25 mg twice daily (n = 14), to 142 +/- 5/78 +/- 3 mmHg at 50 mg twice daily (n = 12), P < 0.01), and to 137 +/- 10/77 +/- 8 mmHg at 100 mg twice daily (n = 6, P < 0.01). The hypotensive effect was sustained over 24 hours. Pulse rate did not change. Plasma renin activity and angiotensin I were decreased after FK906 administration only in patients with increased plasma renin activity. The hypotensive effects of FK906 were not correlated with baseline plasma renin activity. Suppression of the noncirculating tissue renin-angiotensin system may account for the hypotensive action of FK906. The results suggest that FK906 is a promising antihypertensive drug in patients of all ages and with different plasma renin levels.