خانه / (English-news) / Renin Inhibitor + ARB Better Than Either Drug Alone at Lowering BP

Renin Inhibitor + ARB Better Than Either Drug Alone at Lowering BP

Renin Inhibitor + ARB Better Than Either Drug Alone at Lowering BP
A renin inhibitor and an angiotensin receptor blocker are more effective at lowering blood pressure when used in combination than alone, reports a Lancet study, but editorialists question the clinical value of this approach.
Industry-funded researchers randomized some 1800 patients with mean resting diastolic BP between 95 and 110 mm HG to receive aliskiren, valsartan, both drugs, or placebo. After 4 weeks, doses were titrated to the maximum.
After 8 weeks of treatment, patients receiving either drug had lower resting BP than those on placebo, and patients receiving both drugs had lower BP than those on monotherapy. Ambulatory diastolic BP, measured in some 350 patients, fell to a greater extent with combination therapy (mean reduction, 10.3) than with monotherapy (mean reduction, 7.1).
The editorialists discuss the risk for hyperkalemia with these agents and argue that the observed BP reductions are less than what one might expect from combining a renin inhibitor with a diuretic or a calcium-channel blocker, as guidelines recommend. They conclude that “because of the potential life-threatening side-effects … this concept of treatment is unlikely to make it to general practice or even to primary prevention in specialist care.”

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