OBJECTIVES: Aliskiren and ramipril are cornerstones in the treatment of hypertension. Aliskiren is a renin inhibitor, while ramipril is an angiotensin converting enzyme inhibitor. We aim to meta-analyse and compare the effect of aliskiren with ramipril in hypertensive patients after weeks 8 and 24 by measuring the mean difference in systolic blood pressure (mdSBP) and the mean difference in diastolic blood pressure (mdDBP).

METHODS: The search was conducted using the PubMed and Cochrane library databases for eligible randomized clinical trials (RCTs) without year and language restrictions to perform a meta-analysis.

RESULTS: All randomised trials were systematically reviewed whose effects were compared when Aliskiren was presented with Ramipril in hypertensive patients. Four studies were included: two studies (carried out for around 2 months with 1653 patients randomized) and two studies (carried out for around 6 months with 968 patients randomized). There was a significant difference in the mdSBP (mean difference 3.15 mmHg, CI 2.13–4.17, I² = 84%) and mdDBP (mean difference 1.2 mmHg, CI 1.12–1.2, I² = 0%) at 24 weeks. After 8 weeks, the mean difference of diastolic blood pressure was found to be significant (mean difference 0.85 mmHg, CI 0/73-0.97, I² = 0%), but the mean difference of systolic blood pressure was found to be non-significant (mean difference 0.0 mmHg, CI -0.17-0.17, I² = 100%).

CONCLUSIONS: Aliskiren was found to show significant improvement in both systolic and diastolic blood pressure compared with ramipril after 24 weeks.