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Review
. 2017 Jul 19;8(51):89364-89374.
doi: 10.18632/oncotarget.19382. eCollection 2017 Oct 24.

Aliskiren therapy in hypertension and cardiovascular disease: a systematic review and a meta-analysis

Shufang Fu  1   2 , Xin Wen  3 , Fei Han  4 , Yin Long  5 , Gaosi Xu  2
Affiliations
Review

Aliskiren therapy in hypertension and cardiovascular disease: a systematic review and a meta-analysis

Shufang Fu et al. Oncotarget. .

Erratum in

Abstract

The efficacy and safety of aliskiren combination therapy with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in patients with hypertension and cardiovascular disease remains attractive attention. We searched the Cochrane Central Register, the Clinical Trials Registry, EMBASE, MEDLINE and PubMed for relevant literatures up to January 2017. A total of 13 randomized controlled trials (RCTs) with 12222 patients were included in this study, and the combined results indicated that aliskiren in combination therapy with ACEIs or ARBs had remarkable effects in reducing systolic blood pressure (SBP) [weighted mean differences (WMD), -4.20; 95% confidential intervals (CI) -5.44 to -2.97; I2 , 29.7%] and diastolic blood pressure (DBP: WMD, -2.09; 95% CI -2.90 to -1.27; I2 , 0%) when compared with ACEIs or ARBs monotherapy, but with significantly increased the risk of hyperkalaemia [relative risk (RR), 1.45; 95% CI 1.28 to 1.64; I2 ,10.6 %] and kidney injury ( RR, 1.92; 95% CI 1.14 to 3.21; I2 , 0%). Besides, there was no significant difference in the incidence of major cardiovascular events (RR, 0.95; 95% CI 0.89 to 1.02; I2 , 0%) between the combined therapy and ACEIs or ARBs monotherapy. In conclusion, this meta-analysis demonstrated that aliskiren in combination therapy with ACEs/ARBs could control BP effectively, but is associated with increasing risks of hyperkalaemia and kidney injury, and have no benefit in preventing of major cardiovascular events.

Keywords: aliskiren; cardiovascular disease; hyperkalaemia; kidney injury.

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Conflict of interest statement

CONFLICTS OF INTEREST There is not any conflict of interest to report.

Figures

Figure 1
Figure 1. Flow diagram for the selection of studies inclusion in the meta-analysis
Figure 2
Figure 2. Risk of bias graph and risk of bias summary
Figure 3
Figure 3. A: Forest plot shows the risk of secondary outcomes in aliskiren combonation therapy or ACEIs or ARBs monotherapy; B: Comparison of the effect of antihypertension between aliskiren combination therapy and ACEIs or ARBs monotherapy Abbreviations: kidney injury; ACEIs or ARBs: angiotensin converting enzyme inhibitors or angiotensin receptor blockers; SBP: systolic blood pressure; DBP: diastoblic blood pressure
Figure 4
Figure 4. Subgroup analyses of hyperkalaemia and kidney injury in high risk and low risk groups
Figure 5
Figure 5. Sensitivity analysis of hyperkalaemia in patients with hypertension and cardiovascular disease
See this image and copyright information in PMC

References

    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, Jones DW, Materson BJ, Oparil S, Wright JT, Jr, Roccella EJ, National Heart, Lung. Blood Institute Joint National Committee on Prevention. Detection. Evaluation. Treatment of High Blood Pressure. National High Blood Pressure Education Program Coordinating Committee The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–72. - PubMed
    1. Ruggenenti P, Perna A, Gherardi G, Garini G, Zoccali C, Salvadori M, Scolari F, Schena FP, Remuzzi G. Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet. 1999;354:359–64. - PubMed
    1. Flather MD, Yusuf S, Køber L, Pfeffer M, Hall A, Murray G, Torp-Pedersen C, Ball S, Pogue J, Moyé L, Braunwald E, ACE-Inhibitor Myocardial Infarction Collaborative Group Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: a systematic overview of data from individual patients. Lancet. 2000;355:1575–81. - PubMed
    1. Turnbull F, Blood Pressure Lowering Treatment Trialists’ Collaboration Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively-designed overviews of randomised trials. Lancet. 2003;362:1527–35. - PubMed
    1. Batenburg WW, de Bruin RJ, van Gool JM, Müller DN, Bader M, Nguyen G, Danser AH. Aliskiren-binding increases the half life of renin and prorenin in rat aortic vascular smooth muscle cells. Arterioscler Thromb Vasc Biol. 2008;28:1151–57. - PubMed

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