Can a Blood Pressure Rx Unclog Arteries?

Aliskiren may not be effective for treating heart disease

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

Because many heart and vascular health issues are interrelated, a recent study examined whether a blood pressure medication could help prevent clogged arteries in the heart.

The study analyzed a specific medication, aliskiren (brand name Tekturna), normally used to decrease blood pressure by acting on the kidneys. Lowering blood pressure can help treat heart disease.

However, the researchers found that aliskiren did not affect atherosclerosis, the type of heart disease that is the result of clogged arteries.

This medicine did not reduce the amount of fat and cholesterol blocking blood flow in arteries.

"Talk to a cardiologist about your treatment options for heart disease."

Stephen Nicholls, MBBS, PhD, of the South Australian Health and Medical Research Center, and colleagues performed this study in order to see if a certain type of medication had an effect on coronary disease progression.

The type of medication tested was aliskiren, a renin inhibitor.

Atherosclerosis is the thickening of the artery wall and can contribute to raised blood pressure and heart disease. 

The renin-angiotensin-aldosterone system naturally regulates blood pressure in the body. By acting on renin, inhibitors such as aliskiren help to prevent this molecular system from increasing blood pressure.

However, the effect of renin inhibition on the development of coronary artery disease is still not known.

Coronary artery disease is caused by arteries that become clogged with fat and cholesterol. The arteries can become so clogged that they prevent blood from flowing through them, which can result in a heart attack. Heart attacks can sometimes end in permanent heart damage and death.

To test whether renin inhibitors were effective in treating and preventing coronary artery disease, the researchers created a clinical trial to test aliskiren.

The researchers recruited 613 people with coronary artery disease, prehypertension (elevated blood pressure that doesn't qualify as high blood pressure) and two other heart health risk factors.

Each of the participants had an ultrasound of their coronary arteries to determine the extent of their disease. They were then broken up into two groups, one of which received a daily treatment of 300 milligrams of aliskiren. The other group received a placebo (fake medication).

The participants took their respective pills daily for 104 weeks. Another ultrasound was taken after at least 72 weeks of treatment.

The ultrasounds looked for any changes in the volume of fat and cholesterol in the artery walls.

The researchers found that, although the medication did decrease blood pressure, it did not reduce the amount of debris clogging arteries. In other words, the renin inhibitor was found to be ineffective in slowing coronary disease progression.

Aliskiren was associated with a very low risk of negative side effects.

"Among participants with prehypertension and coronary artery disease, the use of aliskiren compared with placebo did not result in improvement or slowing in the progression of coronary atherosclerosis," the study authors concluded.

The study was published in JAMA on September 3.

The research was funded by Novartis Pharmaceuticals. Several of the researchers reported professional affiliations and receiving research support from various pharmaceutical and medical companies.

Review Date: 
September 4, 2013
Last Updated:
September 5, 2013