Inhibition of the RAAS in diabetic patients is known to result in several beneficial effects, independent of their BP lowering effect; Reduction of albumin excretion, prevention of the progression of renal disease and possibly a cardio-protective effect. Valsartan was also found to reduce PWV, and hence arterial stiffness, in diabetic patients independently of its BP lowering effect. Several of these effects had already been evaluated using aliskiren, for example: Nussberger J at al evaluated the effect of aliskiren on atherosclerosis and plaque stabilization in mice, comparing it with atenolol, amlodipine and irbesartan. They found that although they all had a similar blood pressure lowering effect, aliskiren and irbesartan had a beneficial effect on plaque phenotype (including smooth muscle cell content, fibrous cap, lipid core, medial degeneration and macrophage content) whereas amlodipine and atenolol did not. Lu H et al. evaluated the effect of aliskiren on atherosclerosis in LDL receptor deficient mice. They found a significant reduction in atherosclerotic plaque size in the aortic root and arch in the aliskiren treated mice. Aliskiren was found to reduce BP, prevent albuminuria and suppress the renal gene expression of (pro)renin receptors in a model of hypertensive diabetic renal damage in rats. It also exhibited a potential to inhibit prorenin. When using the combination of aliskiren and losartan in patients with DM, aliskiren revealed a reno-protective effect that was independent of its BP lowering effect. The effect of aliskiren on arterial stiffness is yet to be evaluated.