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Year : 2012  |  Volume : 58  |  Issue : 1  |  Page : 32-38

Aliskiren, the first direct renin inhibitor for treatment of hypertension: The path of its development

1 Department of Infectious Diseases (MUHS), Seth GS Medical College and KEM Hospital, Parel, Mumbai, India
2 Department of Cardiology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, India

Correspondence Address:
M Jadhav
Department of Infectious Diseases (MUHS), Seth GS Medical College and KEM Hospital, Parel, Mumbai
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0022-3859.93250

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Standard treatments available today for treating hypertension is diuretics, β-blockers, angiotensin converting enzyme inhibitors (ACEs), angiotensin receptor blockers (ARBs), calcium channel blockers, a-blockers, vasodilators, and centrally acting drugs. It is difficult to achieve the optimized renin angiotensin aldosterone system suppression with currently available antihypertensive agents, because ACE inhibitors, ARBs, and diuretics all activate the compensatory feedback mechanism that increases renin release and increase plasma renin activity. The first orally active direct renin inhibitors (DRIs) were developed in 1980s, including enalkiren, remikiren, and zankiren. However, poor absorption from the gastrointestinal tract, less bioavailability (<2%), short half life, and low potency hindered the development of these compounds. Aliskiren is the first DRI for the treatment of hypertension. Aliskiren is designed through a combination of molecular modeling techniques and crystal structure elucidation. Aliskiren effectively reduces the blood pressure as a mono therapy as well in combination therapy.


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Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow