renineremmers

Renineremmers, in English known as renin inhibitors, are a class of antihypertensive drugs that directly inhibit renin, the enzyme at the top of the renin–angiotensin–aldosterone system (RAAS). By blocking renin, these agents reduce the conversion of angiotensinogen to angiotensin I, leading to lower production of angiotensin II and aldosterone, and thus lower blood pressure.

Mechanism and use: Direct renin inhibitors decrease plasma renin activity and plasma renin concentration, often resulting in a gradual but sustained reduction in blood pressure. They are typically considered for treating essential hypertension and can be used alone or in combination with other antihypertensives.

Examples: Aliskiren is the principal clinically used direct renin inhibitor. It is administered orally and is approved for hypertension in many regions, sometimes in combination with other antihypertensives.

Clinical considerations: Renin inhibitors may be chosen for patients who need additional blood pressure control or who cannot take other RAAS-blocking drugs. Caution is advised in individuals with kidney impairment, pregnancy, or diabetes. Because renin inhibitors affect the same RAAS pathways as ACE inhibitors and ARBs, combined use in certain populations has raised safety concerns and guidelines vary by country.

Side effects and safety: Common adverse effects include dizziness and gastrointestinal symptoms. Hyperkalemia and changes in kidney function can occur, particularly when used with other RAAS blockers. Rare cases of angioedema have been reported. Regulatory guidance emphasizes careful patient selection and monitoring in specific groups.

History and status: Aliskiren was approved for hypertension in 2007 in several regions. Ongoing evaluations continue regarding safety and use in combination therapy, with recommendations differing by jurisdiction.

See also: Renin–angiotensin system, Aliskiren, ACE inhibitors, Angiotensin II receptor blockers.