Aliskiren improves vascular smooth muscle function in the skin microcirculation of type 2 diabetic patients with normal renal function

Objective: The objective of this paper is to study the effect of aliskiren on metabolic parameters and micro- and macrovascular reactivity in individuals diagnosed with or at high risk for developing type 2 diabetes mellitus (T2DM). Research design and methods: We studied 47 T2DM and 41 at-risk individuals in a randomized, double-blinded, placebocontrolled trial. All subjects were treated with 150 mg aliskiren or placebo daily for 12 weeks. Twenty-six (55%) of T2DM and four (8%) at-risk subjects were also treated with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers. Results: Aliskiren treatment was associated with improvement in systolic and diastolic blood pressure and endotheliumindependent vasodilation at the skin microcirculation in those with T2DM but not in those at risk. There were no incidences of hypotension and no significant changes in serum potassium or creatinine levels with aliskiren treatment in either study group. Conclusions: Aliskiren improves blood pressure and vascular smooth muscle function in the skin microcirculation of T2DM patients.