4.1 EFFECT OF ALISKIREN ON VASCULAR REMODELING IN SMALL RETINAL CIRCULATION

DOI

10.1016/j.artres.2015.10.020How to use a DOI?

Abstract

Background: In hypertension changes in small arterial structure are characterized by an increased wall-to-lumen ratio (WLR). These adaptive processes are modulated by the renin angiotensin system. It is unclear whether direct renin inhibitors exert protective effects on small arteries in hypertensive patients.

Methods: In this double-blind, randomized, placebo-controlled study (www.clinicaltrials.gov: NCT01318395) 114 patients with primary hypertension were after 4 weeks of standardized open-label treatment with valsartan 320 mg (run-in phase) randomized to additional therapy with either placebo or aliskiren 300 mg for 8 weeks. Parameter of arteriolar remodeling was WLR of retinal arterioles (80–140 μm) assessed non-invasively and in vivo by scanning laser Doppler flowmetry (Heidelberg Engineering, Germany). In addition, pulse wave analysis (SphygmoCor™, AtCor Medical, Australia) and pulse pressure (PP) amplification were determined.

Results: In the whole study population no clear effect of additional therapy with aliskiren on vascular parameters was documented. When analyses were restricted to patients with vascular remodeling, defined by median of WLR > 0.3326 (n = 57), WLR was reduced after 8 weeks by the treatment with aliskiren compared to placebo (−0.044 ± 0.07 versus 0.0043 ± 0.07, p = 0.015). Consistently, after 8 weeks of on-top treatment with aliskiren there was an improvement of PP amplification compared to placebo (0.025 ± 0.07 versus −0.034 ± 0.08, p = 0.013), indicative of less stiff arteries in the peripheral circulation.

Conclusion: Thus, our data indicate that treatment with aliskiren, given on top of valsartan therapy, improves altered vascular remodeling in hypertensive patients.

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TY  - JOUR
AU  - Christian Ott*
AU  - Agnes Jumar
AU  - Joanna Harazny
AU  - Stephanie Schmidt
AU  - Roland Schmieder
PY  - 2015
DA  - 2015/11/23
TI  - 4.1 EFFECT OF ALISKIREN ON VASCULAR REMODELING IN SMALL RETINAL CIRCULATION
JO  - Artery Research
SP  - 44
EP  - 44
VL  - 12
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2015.10.020
DO  - 10.1016/j.artres.2015.10.020
ID  - Ott*2015
ER  -