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Review | Special issue | Vol 73, No. 1, 2007, pp.47-85
Published online, 7th August, 2007
DOI: 10.3987/REV-07-SR(U)1
Cardiovascular Agents: Renin Inhibitors and Factor Xa Inhibitors

Aparna Kasani, Rajendra Subedi, Michael Stier, Daniel D. Holsworth, and Samarendra N. Maiti*

*Naeja Pharmaceuticals Inc, 4290-91A Street, Edmonton T6E 5V2, Canada

Abstract

Cardiovascular disease is a serious global health problem and the world’s leading cause of death, with an estimated 17 million people dying from it each year. Coronary heart disease (CHD) and stroke account for 20-50% of all deaths in most countries. These two diseases are the first and third cause of death in the industrialized world, and the first and second cause in many developing countries, respectively. Hypertension is a major contributing factor to cardiovascular disease. A number of therapies like diuretics, alpha and beta-blockers, ACE inhibitors and angiotensin receptor blockers (ARBs) are available for the treatment of hypertension. Despite these therapies 35% patients do not achieve blood pressure control goals. In recent years there has been tremendous effort focused on the development of renin inhibitors as a new class of antihypertensive drugs. These inhibitors offer a novel approach to control hypertension by acting further upstream in the RAAS pathway. Thrombosis is also responsible for heart attacks and stroke. To treat thrombosis, two groups of antithrombotic drugs such as thrombolytic and anticoagulant agents, are available. Despite available treatments, there remains a critical need for a safe and orally active anticoagulants. Recently, factor Xa inhibitors have been found to be a promising approach to prevent blood coagulation. This review will highlight the recent developments of renin inhibitors as antihypertensive agents and factor Xa inhibitors as anticoagulants.