ArticleDiabetes care2012
The effect of direct renin inhibition alone and in combination with ACE inhibition on endothelial function, arterial stiffness, and renal function in type 1 diabetes.
Article in Diabetes care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Guideline
- Effect of add-on aliskiren to type 1 angiotensin receptor blocker therapy on endothelial function and autonomic nervous system in hypertensive patients with ischemic heart disease.Journal of clinical hypertension (Greenwich, Conn.) · 2014Trial
- The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus.Cardiovascular diabetology · 2014 · on this mapTrial
- The effect of aliskiren on urinary cytokine/chemokine responses to clamped hyperglycaemia in type 1 diabetes.Diabetologia · 2013Trial
- The Conventional and Alternative Therapeutic Approaches in Arterial Stiffness Management.Pharmaceutics · 2026Review
- Expression of the Renin-Angiotensin System in the Heart, Aorta, and Perivascular Adipose Tissue in an Animal Model of Type 1 Diabetes.International journal of molecular sciences · 2025Article
- Mathematical modeling of antihypertensive therapy.Frontiers in physiology · 2022Article
- Renal Benefits of SGLT 2 Inhibitors and GLP-1 Receptor Agonists: Evidence Supporting a Paradigm Shift in the Medical Management of Type 2 Diabetes.International journal of molecular sciences · 2019Review
- Smooth Muscle Cell-Specific Disruption of the BBSome Causes Vascular Dysfunction.Hypertension (Dallas, Tex. : 1979) · 2019Article
- Elevated plasma cyclic guanosine monophosphate may explain greater efferent arteriolar tone in adults with longstanding type 1 diabetes: A brief report.Journal of diabetes and its complications · 2019Article
- SGLT-2 Inhibitors in Heart Failure: Implications for the Kidneys.Current heart failure reports · 2017Review
- Role of SGLT2 Inhibitors in Patients with Diabetes Mellitus and Heart Failure.Current heart failure reports · 2017Review
- Diabetic nephropathy: Time to withhold development and progression - A review.Journal of advanced research · 2017Review
- Influence of sex on hyperfiltration in patients with uncomplicated type 1 diabetes.American journal of physiology. Renal physiology · 2017Article
- Promise of SGLT2 Inhibitors in Heart Failure: Diabetes and Beyond.Current treatment options in cardiovascular medicine · 2017Review
- Sodium-Glucose Cotransporter-2 Inhibition and the Glomerulus: A Review.Advances in therapy · 2016Review
- Impact of Renin-Angiotensin System Inhibitors on Long-Term Clinical Outcomes of Patients With Coronary Artery Spasm.Journal of the American Heart Association · 2016Article
- Central wave reflection is associated with peripheral arterial resistance in addition to arterial stiffness in subjects without antihypertensive medication.BMC cardiovascular disorders · 2016Article
- Early changes in cardiovascular structure and function in adolescents with type 1 diabetes.Cardiovascular diabetology · 2016Observational
- Clinical Significance of Endothelial Dysfunction in Essential Hypertension.Current hypertension reports · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDiabetes is associated with renin-angiotensin system (RAS) activation, leading to renal and systemic vascular dysfunction that contribute to end-organ injury and significant morbidity. RAS blockade with ACE inhibitors reduces, but does not abolish, RAS effects. Accordingly, our aim was to determine if direct renin inhibition alone, and in combination with an ACE inhibitor, corrects early hemodynamic abnormalities associated with type 1 diabetes. RESEARCH DESIGN AND
methodsArterial stiffness (augmentation index), flow-mediated vasodilatation (FMD), and renal hemodynamic function (inulin and paraaminohippurate clearance) were measured at baseline under clamped euglycemic and hyperglycemic conditions (n = 21). Measures were repeated after 4 weeks of aliskiren therapy and again after aliskiren plus ramipril.
resultsBlood pressure-lowering effects of aliskiren were similar during clamped euglycemia and hyperglycemia. Combination therapy augmented this effect under both glycemic conditions (P = 0.0005). Aliskiren reduced arterial stiffness under clamped euglycemic and hyperglycemic conditions, and the effects were augmented by dual RAS blockade (-3.4 ± 11.2 to -8.0 ± 11.5 to -14.3 ± 8.4%, respectively, during euglycemia, P = 0.0001). During clamped euglycemia, aliskiren increased FMD; dual therapy exaggerated this effect (5.1 ± 3.3 to 7.5 ± 3.0 to 10.8 ± 3.5%, repeated-measures ANOVA, P = 0.0001). Aliskiren monotherapy caused renal vasodilatation during clamped hyperglycemia only. In contrast, dual therapy augmented renal vasodilatory effects during clamped euglycemia and hyperglycemia.
conclusionsIn patients with uncomplicated type 1 diabetes, aliskiren-based dual RAS blockade is associated with greater arterial compliance, FMD, and renal vasodilatation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.