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Aliskiren/amlodipine combination for the treatment of hypertension.

机译:阿利吉仑/氨氯地平联合治疗高血压。

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摘要

The challenge of managing hypertension is exemplified by the limited success of monotherapy and necessity for multiple drug regimens targeting complimentary pathways. Recent evidence suggests that combination therapy including angiotensin-converting enzyme (ACE) inhibitors and calcium channel blockers (CCBs) provides blood pressure control while reducing cardiovascular mortality and morbidity over ACE inhibitor/diuretic therapy. However, CCBs, ACE inhibitors and angiotensin receptor blockers all increase plasma renin activity (PRA), promoting angiotensin I accumulation and angiotensin II production through alternative pathways. While the clinical ramifications of this and other compensatory pathways activating the renin-angiotensin-aldosterone system are unclear, the recently approved aliskiren/amlodipine antihypertensive combination pill has been shown to decrease PRA via aliskiren's direct inhibition of renin. The purpose of this monograph is to review the mechanisms of action, pharmacodynamics, and safety and efficacy profile of the aliskiren/amlodipine combination pill.
机译:单一疗法的成功有限以及针对靶向互补途径的多种药物治疗方案的必要性说明了控制高血压的挑战。最近的证据表明,与血管紧张素转换酶(ACE)抑制剂和钙通道阻滞剂(CCB)结合使用的组合疗法比ACE抑制剂/利尿剂疗法可控制血压,同时降低心血管疾病的死亡率和发病率。但是,CCB,ACEI抑制剂和血管紧张素受体阻滞剂均会增加血浆肾素活性(PRA),从而通过替代途径促进血管紧张素I的积累和血管紧张素II的产生。虽然尚不清楚激活肾素-血管紧张素-醛固酮系统的这种和其他补偿途径的临床影响,但最近批准的阿利吉仑/氨氯地平降压联合药已显示出通过阿利吉仑直接抑制肾素来降低PRA。本专着的目的是回顾阿利吉仑/氨氯地平联合丸的作用机理,药效学以及安全性和有效性。

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