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Aliskiren for the treatment of essential hypertension under real-life practice conditions: design and baseline data of the prospective 3A registry

Item Type:Article
Title:Aliskiren for the treatment of essential hypertension under real-life practice conditions: design and baseline data of the prospective 3A registry
Creators Name:Zeymer, U. and Dechend, R. and Deeg, E. and Kaiser, E. and Senges, J. and Pittrow, D. and Schmieder, R.
Abstract:BACKGROUND: The renin-angiotensin system (RAS) is a key target for blood pressure control and for cardiovascular and renal protection. Aliskiren is the first-in-class direct oral inhibitor of renin that controls the rate-limiting step in the RAS cascade. So far little is known about the use and efficacy of aliskiren in the treatment of essential hypertension under clinical practice conditions. METHODS: The 3A registry was an open, prospective cohort study (observational registry) of 14,988 patients in 899 offices throughout Germany. Consecutive patients were eligible for inclusion if their physician had decided to modify their antihypertensive therapy. This included treatment with aliskiren or an angiotensin converting enzyme inhibitor (ACE-I)/angiotensin receptor blocker (ARB) or agents not blocking the RAS, alone or on top of an existing drug regimen. RESULTS: Mean age of patients was 65 years, their mean body mass index was 28.2 kg/m(2) 53.5% were men, 36% working, 90% in statutory health insurance and 26% in any disease management programme. Patients in the aliskiren and the RAS groups compared with the non-RAS group were older, more often men, had a longer history of hypertension, and had a higher prevalence of comorbidities (diabetes, chronic heart failure, ischaemic heart disease, renal disease). Mean systolic, but not diastolic blood pressure was substantially higher in the aliskiren group (158/91 mmHg vs. 154/89 mmHg in ACE-I/ARB vs. 152/89 mmHg in non-RAS). Mean number of antihypertensive drugs was higher in the aliskiren group compared with the other groups (3.0 drugs vs. 2.5 in ACE-I/ARB vs. 1.6 in non-RAS; p < 0.0001). CONCLUSIONS: In this large cohort of outpatients with hypertension, aliskiren was used mainly in patients with more severe stages of hypertension and those with concomitant diseases such as diabetes mellitus and impaired renal function. The 3A registry will provide important information about the use and efficacy of aliskiren in a real-life setting.
Keywords:Amides, Angiotensin Receptor Antagonists, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Blood Pressure, Drug Substitution, Drug Utilization Review, Fumarates, Hypertension, Prospective Studies, Registries, Risk Factors
Source:International Journal of Clinical Practice
ISSN:1368-5031
Publisher:Wiley-Blackwell (U.K.)
Volume:66
Number:3
Page Range:251-261
Date:March 2012
Official Publication:https://doi.org/10.1111/j.1742-1241.2012.02893.x
PubMed:View item in PubMed

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