Clinical Benefit of Sacubitril/Valsartan for Hypertensive Patients in Daily Practice and Predictors of Its Antihypertensive Effect.

Horio, Takeshi; Iwashima, Yoshio; Yoshiyama, Minoru; Fukuda, Daiju; Hasegawa, Takamasa; Fujimoto, Kohei

Horio, Takeshi; Iwashima, Yoshio; Yoshiyama, Minoru; Fukuda, Daiju; Hasegawa, Takamasa; Fujimoto, Kohei.

Afiliación

Horio T; Department of Cardiovascular Medicine, Ishikiriseiki Hospital Osaka Japan.
Iwashima Y; Department of Internal Medicine, Kansai Medical University Kori Hospital Osaka Japan.
Yoshiyama M; Department of Internal Medicine, Daito Central Hospital Osaka Japan.
Fukuda D; Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine Osaka Japan.
Hasegawa T; Department of Diabetes and Metabolism, Ishikiriseiki Hospital Osaka Japan.
Fujimoto K; Department of Cardiovascular Medicine, Ishikiriseiki Hospital Osaka Japan.

Circ Rep ; 6(7): 248-254, 2024 Jul 10.

Article en En | MEDLINE | ID: mdl-38989102

ABSTRACT

ABSTRACT

Background:

The blood pressure (BP)-lowering effect of sacubitril/valsartan (Sac/Val) is greater than that of angiotensin II receptor blockers (ARBs) but in in real-world clinical practice, Sac/Val is used in a variety of patterns other than switching from ARBs. In the present study we investigated the effects of Sac/Val on BP and biochemical parameters when switching from or adding it to various antihypertensive drugs and examined what factors could be predictors of the antihypertensive effect of Sac/Val. Methodsâandâ

Results:

In 108 hypertensive patients treated with antihypertensive agents (including 4 naïve cases), clinic BP and various biochemical parameters were assessed before and after switching to/adding Sac/Val (200 mg/day). Systolic and diastolic BPs significantly decreased after treatment with Sac/Val (P<0.0001, respectively). As for biochemical parameters, alanine aminotransferase, triglycerides, C-reactive protein, and uric acid significantly decreased after administration of Sac/Val, but renal function, B-type natriuretic peptide, and plasma renin activity (PRA) did not change before or after treatment with Sac/Val. Multiple regression analysis revealed that low PRA and high baseline systolic BP were independent determinants of systolic BP reduction after Sac/Val treatment.

Conclusions:

Sac/Val is beneficial for poorly controlled hypertension in daily clinical practice and low PRA may be a predictor of the antihypertensive effect of switching to/adding Sac/Val.

Palabras clave

Angiotensin receptor-neprilysin inhibitor; Antihypertensive effect; Metabolic parameters; Plasma renin activity; Renal function

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Circ Rep Año: 2024 Tipo del documento: Article Pais de publicación: Japón