Aliskiren was added to enalapril in individuals with chronic heart failure, however there was no improvement in the side effects in hypertension. In comparison to enalapril, noninferiority was not demonstrated for aliskiren.
Antihypertensive medications like enalapril have varying effects on blood pressure regulation, so for a synergistic effect, these medications are typically combined. Ninety percent of hypertension patients have an unknown underlying etiology. As a result, the primary function of antihypertensive medications such as enalapril is to change the body's regulatory systems (such as the renin-angiotensin-aldosterone system and baroreceptors) in order to maintain normal blood pressure. Enalapril at a dose of 5 or 10 mg twice daily for 2336 patients, aliskiren at a dose of 300 mg once daily for 2340 patients, or both therapies for 2340 patients of hypertension, to one of three groups (combination therapy). Heart failure hospitalization or death from cardiovascular causes made up the majority of the composite outcome in hypertension.
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