Int. J. Mol. Sci. 2013, 14(8), 15361-15375; doi:10.3390/ijms140815361
Article

Addition of Aliskiren to Angiotensin Receptor Blocker Improves Ambulatory Blood Pressure Profile and Cardiorenal Function Better than Addition of Benazepril in Chronic Kidney Disease

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Received: 13 May 2013; in revised form: 25 June 2013 / Accepted: 28 June 2013 / Published: 24 July 2013
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: An altered ambulatory blood pressure (BP) and heart rate (HR) profile is related to chronic kidney disease (CKD) and cardiorenal syndrome. In this study, we examined the effects of aliskiren, when added to angiotensin II type 1 receptor blockers, on ambulatory BP and cardiorenal function in CKD. Thirty-six hypertensive CKD patients were randomly assigned to the aliskiren add-on group (n = 18) or the benazepril add-on group (n = 18). Ambulatory BP and cardiorenal function parameters were measured at baseline and 24 weeks after treatment. Compared with the benazepril group, nighttime systolic BP variability in the aliskiren group was lower after treatment. Albuminuria was decreased in the aliskiren group, but not in the benazepril group. In addition, left ventricular mass index (LVMI) was significantly lower in the aliskiren group than in the benazepril group after treatment. In the aliskiren group, multivariate linear regression analysis showed an association between changes in albuminuria and changes in nighttime systolic BP. Furthermore, there were associations between changes in LVMI and changes in daytime HR variability, as well as between changes in LVMI and changes in plasma aldosterone concentration. These results suggest that aliskiren add-on therapy may be beneficial for suppression of renal deterioration and pathological cardiac remodeling through an improvement that is effected in ambulatory BP and HR profiles.
Keywords: albuminuria; ambulatory blood pressure; direct renin inhibitor; left ventricular hypertrophy; hypertension (kidney)
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MDPI and ACS Style

Ohsawa, M.; Tamura, K.; Kanaoka, T.; Wakui, H.; Maeda, A.; Dejima, T.; Azushima, K.; Uneda, K.; Kobayashi, R.; Tsurumi-Ikeya, Y.; Toya, Y.; Fujikawa, T.; Umemura, S. Addition of Aliskiren to Angiotensin Receptor Blocker Improves Ambulatory Blood Pressure Profile and Cardiorenal Function Better than Addition of Benazepril in Chronic Kidney Disease. Int. J. Mol. Sci. 2013, 14, 15361-15375.

AMA Style

Ohsawa M, Tamura K, Kanaoka T, Wakui H, Maeda A, Dejima T, Azushima K, Uneda K, Kobayashi R, Tsurumi-Ikeya Y, Toya Y, Fujikawa T, Umemura S. Addition of Aliskiren to Angiotensin Receptor Blocker Improves Ambulatory Blood Pressure Profile and Cardiorenal Function Better than Addition of Benazepril in Chronic Kidney Disease. International Journal of Molecular Sciences. 2013; 14(8):15361-15375.

Chicago/Turabian Style

Ohsawa, Masato; Tamura, Kouichi; Kanaoka, Tomohiko; Wakui, Hiromichi; Maeda, Akinobu; Dejima, Toru; Azushima, Kengo; Uneda, Kazushi; Kobayashi, Ryu; Tsurumi-Ikeya, Yuko; Toya, Yoshiyuki; Fujikawa, Tetsuya; Umemura, Satoshi. 2013. "Addition of Aliskiren to Angiotensin Receptor Blocker Improves Ambulatory Blood Pressure Profile and Cardiorenal Function Better than Addition of Benazepril in Chronic Kidney Disease." Int. J. Mol. Sci. 14, no. 8: 15361-15375.

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