Direct renin inhibitor aliskiren in women with menopausal metabolic syndrome and arterial hypertension
https://doi.org/10.15829/1728-8800-2011-4-33-38
Abstract
Aim. To study the effectiveness of a direct renin inhibitor, aliskiren, in patients with menopausal metabolic syndrome (MMS), and to assess aliskiren effects on blood pressure (BP), carbohydrate and lipid metabolism parameters, microalbuminuria, and arterial stiffness.
Material and methods. The study included 23 women with MMS, to whom aliskiren monotherapy (150-300 mg/d) was administered. At baseline and in the end of the study, anthropometry, carbohydrate and lipid metabolism parameters assessment, 24-hour BP monitoring, and arterial stiffness assessment by volume sphygmography were performed.
Results. By the end of the study, most parameters of circadian BP profile significantly decreased. Target levels of systolic and diastolic BP were achieved in 80 % of the patients. There was a significant reduction in postprandial glucose levels. According to the volume sphygmography results, a decrease in arterial stiffness was accompanied by a significant reduction in pulse wave velocity and augmentation index, with normalization of the former parameter.
Conclusion. Aliskiren therapy demonstrated not only high antihypertensive effectiveness in MMS patients, but also a reduction in postprandial glucose levels and arterial stiffness.
About the Authors
Yu. V. Zhernakova
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
Russian Federation
Moscow
Russian Federation
Moscow
V. B. Mychka
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
Russian Federation
Moscow
Russian Federation
Moscow
Yu. A. Ponomarev
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
Russian Federation
Moscow
Russian Federation
Moscow
S. N. Tolstov
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
Russian Federation
Moscow
Russian Federation
Moscow
E. V. Tishina
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
Russian Federation
Moscow
Russian Federation
Moscow
K. P. Ivanov
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
Russian Federation
Moscow
Russian Federation
Moscow
I. E. Chazova
A.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex
Russian Federation
Moscow
Russian Federation
Moscow
References
1. Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Информированность, лечение, контроль. Профил забол укреп здор 2001; 2: 3-7.
2. Wassertheil-Smoller S, Anderson G, Psaty BM, et al. Hypertension and its treatment in postmenopausal women: baseline data from the Women’s Health Initiative. Hypertension 2000; 36: 780-9.
3. Reckelhoff JF. Basic research into the mechanisms responsible for postmenopausal hypertension. Int J Clin Pract 2004; 58 (Suppl 139): 13-9.
4. Глезер М.Г. Результаты Российского исследования эффективности и безопасности Диротона при артериальной гипертензии под контролем суточного мониторирования артериального давления DESIRE. Гендерные различия. Пробл женск здоровья 2007; 1: 5-15.
5. Safar ME, Smulyan H. Hypertension in women. Am J Hypertens 2004; 17: 82-7.
6. Sevre K, Lefrandt JD, Nordby G, et al. Autonomic function in hypertensive and normotensive subjects: the importance of gender. Hypertension 2001; 37: 1351-6.
7. Диагностика и лечение артериальной гипертензии. Российские рекомендации (третий пересмотр). Кардиоваск тер профил 2008; Прил.2.
8. ESH-ESC Guidelines Committee. 2009 guidelines for the management of hypertension. J Hypertension 2009; 27.
9. Staton A. Therapeutic potential of rennin inhibitors in the management of cardiovascular disorders. Am J Cardiovasc Drugs 2003; 3: 389-94.
10. Azizi M, Webb R, Nussberger, et al. Renin inhibitor with aliskiren: where are we now, and where are we going? J Hypertens 2006; 24: 243-56.
11. O’Brien E, Barton J, Nussberger J, et al. Aliskiren reduces blood pressure and suppresses plasma rennin activity in combination with thiazide diuretic, an angiotensin-converting enzyme ingibitor, or an angiotensin receptor blocker. Hypertension 2007; 49: 276-84.
12. Villami A, Chrysant SG, Calhoun D, et al. Renin ingibitor with aliskiren provides additive antihypertensive efficancy when used in combination with hydrochlorthiazide. J Hypertens 2007; 25: 217-26.
13. Littlejohn TW 3rd, Trenkwalder P, Hollanders G, et al. Longterm safety, tolerability and efficacy of combination therapy with aliskiren and amlodipine in patients with hypertension. Curr Med Res Opin 2009; 25: 951-9.
14. Parving HH, Persson F, Lewis JB, et al. AVOID Study Investigators. Aliskiren combined with losartan in type 2 diabetes and nephropathy. N Engl J Med 2008; 358: 2433-46.
15. Solomon SD, Appelbaum E, Manning WJ, et al. Aliskiren in Left Ventricular Hypertrophy (ALLAY) Trial Investigators. Effect of the direct rennin inhibitor aliskiren, the angiotensin receptor blocker losartan, or both on ventricular mass in patients with hypertension and left ventricular hypertrophy. Circulation 2009; 119: 530-7.
16. Seed A, Gardner R, McMurray J, et al. Neurohumoral effects of the new orally active inhibitor, aliskiren, in chronic heart failure. Eur J Heart Fail 2007; 9: 1120-7.
17. Gardner RS, Ozalp F, Murday AJ, et al. N-terminal pro-brain natriuretic peptide. A new gold standard in predicting mortality in patients with advanced heart failure. Eur Hert J 2003; 24: 1735-43.
18. Bramlage P, Pittrow D, Wittchen HU, et al. Hypertension in overweight and obese primary care patients is highly prevalent and poorly controlled. AJH 2004; 17: 904-10.
19. Sharma AM, Wittchen HU, Krause P, et al. Physician and self reported prevalence of hypertension in primary care in Germany. J Hypertens 2004; 22: 479-86.
20. Prescott MF, Boye SW, Breton S, et al. Antihypertensive efficacy of the direct renin inhibitor aliskiren when added to hydrochlorthiazide treatment in patients with extreme obesity and hypertension. J Hypertens 2009; 69: 833-84.
21. Jordan J, Engely S, Boye SW, et al. Direct renin inhibition with aliskiren in obese patients with arterial hypertension. J Hypertens 2007; 49: 1047-55.
22. Uresin Y, Taylor AA, Kilo C, et al. Aliskiren monotherapy lowers blood pressure more effectively than ramipril monotherapy in patients with diabetes and grade 2 hypertension: subgroupe analysis of an 8-week, double-blind trial. J Hypertens 2008; 26 (suppl 1).
Review
For citations:
Zhernakova Yu.V., Mychka V.B., Ponomarev Yu.A., Tolstov S.N., Tishina E.V., Ivanov K.P., Chazova I.E. Direct renin inhibitor aliskiren in women with menopausal metabolic syndrome and arterial hypertension. Cardiovascular Therapy and Prevention. 2011;10(4):33-38. (In Russ.) https://doi.org/10.15829/1728-8800-2011-4-33-38
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