Clinical Medicine Reviews in Women's Health

Despite the availability of a wide range of antihypertensive medications, about 45.5% of treated patients in the US fail to achieve a blood pressure control target of <140/90 mmHg; for this reason, in the last two years, some emerging treatments have become available such as aliskiren, a renin inhibitor. A lot of trials showed that aliskiren proved to be safe and effective in monotherapy in reducing blood pressure, with a blood pressure-lowering effect similar, if not superior, to that of other first-line antihypertensive agents, and to be safe also in combination with various other antihypertensive medications. However, recently the European Medicines Agency decided to early terminate the ALTITUDE study, due to more cases of stroke, renal complications, hyperkalemia and hypotension in patients who received aliskiren compared with patients who received a placebo. Given these discrepancies, we conducted a review about the emerging pharmacotherapies for the management of hypertension focusing our attention on the latest class of antihypertensive drugs become available, such as renin inhibitor aliskiren. After an accurate review of all the most important studies conducted, we can conclude that aliskiren proved to be safe and well tolerated and to have some protective effects on heart and kidney, not observed with the other drugs. However, until further data will not be available, aliskiren should not be prescribed in combination with ACE inhibitors or ARBs. In combination with other anti-hypertensive drugs, instead, aliskiren should be considered for the treatment of hypertension in not well controlled hypertensive patients.