Commentary - Journal of Clinical Endocrinology Research (2025) Volume 8, Issue 1

Aliskiren in managing hypertension: Current insights and future perspectives.

Kalathil K Sureshkumar ^*

Department of Nephrology and Hypertension, Allegheny General Hospital, Pennsylvania, USA

Corresponding Author:

Kalathil K Sureshkumar
Department of Nephrology and Hypertension
Allegheny General Hospital, Pennsylvania, USA
E-mail: ksureshk@wpahs.org

Received: 05-Apr-2024, Manuscript No. AAJCER-24-131484; Editor assigned: 07-Apr-2024, AAJCER-24-131484 (PQ); Reviewed: 20-Apr-2024, QC No. AAJCER-24-131484; Revised: 07-Apr-2025, Manuscript No. AAJCER-24-131484 (R); Published: 14-Apr-2025, DOI: 10.35841/AAJCER.8.1.184

Citation: Sureshkumar KK. Aliskiren in managing hypertension: Current insights and future perspectives. J Clin Endocrinol Res.2025; 8(1):184

Keywords

Hypertension, Aliskiren, Armamentarium, Antihypertensive, Hyperkalemia, Renal dysfunction.

Introduction

Hypertension, characterized by elevated blood pressure, is a leading cause of cardiovascular morbidity and mortality worldwide. Despite the availability of numerous antihypertensive medications, many patients fail to achieve adequate blood pressure control, highlighting the need for novel therapeutic approaches. Aliskiren, the first-in-class direct renin inhibitor, represents a promising option for the management of hypertension by targeting the Renin-Angiotensin-Aldosterone System (RAAS) at its point of origin. This research article aims to provide a comprehensive overview of the role of Aliskiren in managing hypertension, with a focus on its pharmacology, efficacy, safety, and clinical implications.

Pharmacology of Aliskiren

Aliskiren exerts its antihypertensive effects by selectively inhibiting renin, the rate-limiting enzyme in the RAAS cascade, thereby reducing the production of angiotensin I and ultimately angiotensin II. By directly blocking renin activity, Aliskiren effectively suppresses the RAAS, leading to vasodilation, sodium excretion, and blood pressure reduction. Unlike other antihypertensive agents that target downstream components of the RAAS, such as ACE inhibitors and Angiotensin Receptor Blockers (ARBs), aliskiren offers a unique mechanism of action with potential advantages in blood pressure control.

Efficacy and safety of Aliskiren

Clinical trials have demonstrated the efficacy of Aliskiren in lowering blood pressure in patients with hypertension, both as monotherapy and in combination with other antihypertensive agents. Aliskiren has been shown to provide comparable or even superior blood pressure reductions compared to traditional antihypertensive medications, including ACE inhibitors, ARBs, and calcium channel blockers. Additionally, Aliskiren exhibits a favorable safety profile, with low rates of adverse events such as hyperkalemia, renal dysfunction, and cough, commonly associated with other RAAS inhibitors.

Clinical implications and future perspectives

The use of Aliskiren in clinical practice holds significant implications for the management of hypertension and cardiovascular risk reduction. Emerging evidence suggests that Aliskiren may offer additional cardiovascular benefits beyond blood pressure lowering, including reductions in target organ damage, cardiovascular events, and mortality. Furthermore, ongoing research is exploring the potential role of Aliskiren in special populations, such as patients with diabetes, chronic kidney disease, and heart failure. Future studies are warranted to further elucidate the long-term efficacy and safety of Aliskiren, as well as its optimal place in the management of hypertension and cardiovascular disease.

Conclusion

Aliskiren represents a valuable addition to the armamentarium of antihypertensive medications, offering a unique mechanism of action and potential cardiovascular benefits beyond blood pressure reduction. As our understanding of the role of Aliskiren in hypertension and cardiovascular disease continues to evolve, it is imperative to integrate this knowledge into clinical practice to optimize patient outcomes. Collaborative efforts between clinicians, researchers, and policymakers are essential to further elucidate the therapeutic potential of Aliskiren and improve hypertension management on a global scale.