Aliskiren in an alternate-day administration schedule in hypertensive albuminuric patients

作者：Spanos Georgios; Kalaitzidis Rigas G; Karasavvidou Despina P; Zikou Xanthi; Siamopoulos Kostas C^*

来源：Blood Pressure Monitoring, 2014, 19(6): 359-365.

DOI：10.1097/MBP.0000000000000077

• albuminuria
• aliskiren
• alternative-day administration
• blood pressure
• central hemodynamics

Objective It has been suggested that aliskiren has a long half-life and maintains a blood pressure (BP)-lowering effect following a missed dose. We tested the hypothesis that every other day (eod) administration of aliskiren has the same effects as the once daily (od) dosing in albuminuric hypertensive patients. %26lt;br%26gt;Methods Fifteen hypertensive patients, after a 4-week wash-out period on clonidine, received 300 mg aliskiren od as the sole treatment. In patients who remained out of target, other nonrenin-angiotensin system blockers were added. Patients who completed a 24-week (w24) treatment period were switched to eod administration of aliskiren for an additional period of 24 weeks (w48). %26lt;br%26gt;Results Thirteen patients completed the full study protocol. The mean office BP was reduced at the end of w24 (-9/3 mmHg), a reduction that continued to be observed at w48 (-11/1 mmHg). At the end of the study, the 48 h ambulatory BP monitoring was divided into two 24 h periods. The mean 24 h systolic BP, and the mean daytime systolic and diastolic BP were significantly lower (P %26lt; 0.05) in the first 24 h (when aliskiren was taken) compared with the second period. Central hemodynamics showed no significant differences at any time during monitoring. Administration of aliskiren resulted in a median reduction of urine albumin/creatinine ratio of 103 mg/g (od) and 102 mg/g (eod). Differences in plasma renin activity, plasma renin concentration, and aldosterone-level measurements were not significant. %26lt;br%26gt;Conclusion The BP-lowering effect of eod aliskiren administration, although adequate, is less efficient compared with od administration, despite the fact that in terms of reducing albuminuria, it appears to be effective.

• 出版日期2014-12