Monday, May 29, 2006

Latest in Hypertension

The 21st Annual Scientific meeting of the American Society of Hypertension is going on now in New York. I am sure one of the highlights is the two presentations on the new class of anti-hypertensive agent from Novartis. Aliskiren is an oral anti-renin agent that attacks the first substrate in the renin-angiotensin-aldosterone system. At this meeting, Dr J Mitchell of Houston and A.Villamill of Argentina, presented their separate experience on the safety and efficacy of Aliskiren, in their hypertensive patient cohort. Basically, aliskiren alone is as good as hydrochlorthiazide alone and aliskiren and HCT in combination is even better. The results look good and encouraging.

What fascinates me is that this drug is developed based on our current understanding of the pathophysiology of hypertension. There is proof of concept. This is surely a good illustration of scientific medicine. I am sure that there are many oral renin antagonist in the pipeline, but Novartis is leading the way. I am certain that Novartis will try and combine this oral anti-renin agent with their established ARB (Valsartan) or even aliskiren + HCT + Valsartan. We await further evidence before we can know it's role in our armentarium in the treatment of hypertension.

The good news is that the fight against hypertension has one more new bullet. The bad news is that I am sure Aliskiren will not come cheap.

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