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首页> 外文期刊>The journal of clinical hypertension. >Renin inhibitors.
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Renin inhibitors.

机译：肾素抑制剂。

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KEY POINTS AND PRACTICAL RECOMMENDATIONS: * Aliskiren, the sole oral renin inhibitor approved by the US Food and Drug Administration, is indicated for the treatment of hypertension, either as monotherapy or in combination, with reductions in blood pressure similar to other agents. * Early evidence suggests that aliskiren confers additional benefit in patients with diabetic nephropathy. Data are not yet available to determine whether protection will extend to cardiovascular disease. * No initial dosage adjustment is required in elderly patients or for patients with mild to severe renal impairment; however, clinical experience is limited in patients with significant renal impairment, and with renal artery stenosis. * It appears rational to combine aliskiren with agents that otherwise increase plasma renin activity, including thiazide diuretics, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. * While there is a reactive rise in renin in response to aliskiren, probably larger than that induced by angiotensin receptor blockers and angiotensin-converting enzyme inhibitors, there is no evidence that this rise is harmful. * In placebo-controlled studies, the incidence of edema anywhere in the body was 0.4% with aliskiren compared with 0.5% with placebo. It is unknown whether angioedema rates are higher in blacks with aliskiren. * Aliskiren is associated with a slight increase in cough, with rates of about one third to one half seen with angiotensin-converting enzyme inhibitors. * Increases in serum potassium >5.5 meq/L were infrequent in patients with essential hypertension treated with aliskiren alone (0.9% compared with 0.6% with placebo).
机译：要点和实用建议：* Aliskiren是美国食品和药物管理局批准的唯一口服肾素抑制剂，适用于高血压的治疗，既可作为单一疗法，也可与其他疗法联合使用，与其他药物相似，可降低血压。 *早期证据表明，阿利吉仑可为糖尿病肾病患者带来更多益处。尚无数据来确定保护是否会扩展到心血管疾病。 *老年患者或轻至重度肾功能不全患者无需调整初始剂量;但是，对于有严重肾功能不全和肾动脉狭窄的患者，临床经验有限。 *将阿利吉仑与其他可增加血浆肾素活性的药物（包括噻嗪类利尿剂，血管紧张素转化酶抑制剂和血管紧张素受体阻滞剂）合用似乎是合理的。 *虽然肾上腺素对阿利吉仑有反应性升高，可能比血管紧张素受体阻滞剂和血管紧张素转化酶抑制剂诱导的升高，但没有证据表明这种升高是有害的。 *在安慰剂对照研究中，阿利吉仑在人体任何部位的水肿发生率为0.4％，而安慰剂为0.5％。尚不知道阿利吉仑治疗的黑人的血管性水肿发生率是否更高。 * Aliskiren与咳嗽的轻微增加有关，使用血管紧张素转换酶抑制剂的比率约为三分之一至一半。 *单独使用阿利吉仑治疗的原发性高血压患者血钾升高不超过5.5 meq / L（0.9％，而安慰剂为0.6％）。

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