In a nutshell
This analysis reviewed recently reported studies that compared the effect on blood pressure reduction and adverse events between amlodipine and aliskiren alone (monotherapy), or amlodipine-aliskiren (AmAl) combination therapy.
Some background
Aliskiren (Tekturna) is a drug used to treat high blood pressure (hypertension). It works by blocking an enzyme (rennin) in the body that is necessary to produce a substance (angiotensin II) that causes blood vessels to tighten. As a result, the blood vessels relax and this decreases the blood pressure. Amlodipine (Norvasc) is another antihypertensive drug (blood pressure lowering drug) that blocks the transport of calcium into the smooth muscle cells lining the coronary arteries (blood vessels that supply blood and oxygen to the heart) and other arteries of the body. Since calcium is important in muscle contraction, blocking calcium transport relaxes the muscles of the arteries, which lowers the blood pressure. Any of these drugs may be used alone or in combinations with other antihypertensive medicines to reduce blood pressure. This study aimed to review the benefits and side effects of using either amlodipine or aliskiren monotherapy or the two drugs combined.
Methods & findings
This research reviewed 7 clinical trials including a total of 6074 participants. In an analysis of AmAl combination therapy versus aliskiren alone, 3 trials were analyzed. These trials showed that in the group treated with AmAl combination the average reduction in systolic blood pressure or SBP (pressure in the arteries when the heart beats) was -10.42 mmHg and in diastolic blood pressure or DBP (pressure in the arteries between heart beats) was -6.6 mmHg compared to aliskiren monotherapy. The other 4 trials were used in analysis of AmAl combined therapy versus amlodipine alone. Results showed that combination therapy was superior in reducing both SBP and DBM compared to amlodipine monotherapy by an average of -4.85 mmHg and -2.91 mmHg, respectively.
No differences were found in terms of adverse events between combination therapy and monotherapy. However, side effects such as swelling in the limbs and low potassium levels were more common in patients treated with amlodipine alone than in AmAl combination therapy group.
The bottom line
In summary, this analysis showed that amlodipine and aliskiren combination therapy was more effective and as safe as using either of the two drugs alone.
What’s next?
Consult your physician on the most appropriate treatment for your situation.
Published By :
PLOS ONE
Date :
Jul 29, 2013
