Efficacy and Safety of Sacubitril/Allisartan for the Treatment of Primary Hypertension (JACC Asia September 2024)-Article: Efficacy and Safety of Sacubitril/Allisartan for the Treatment of Primary Hypertension

Article: Efficacy and Safety of Sacubitril/Allisartan for the Treatment of Primary Hypertension

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This study aimed to assess the efficacy and safety of sacubitril/allisartan compared to olmesartan in treating mild-to-moderate hypertension in Chinese patients. Hypertension remains a significant health issue in China, with poor control rates despite available treatments. <br /><br />A total of 1,197 patients aged 18 to 75 were randomized into three groups to receive either sacubitril/allisartan 240 mg, sacubitril/allisartan 480 mg, or olmesartan 20 mg daily for 12 weeks. Following this, an extended and prolonged treatment phase was conducted over additional 40 weeks.<br /><br />The primary endpoint was the reduction in mean sitting systolic blood pressure (msSBP) at 12 weeks. Sacubitril/allisartan 240 mg showed non-inferiority to olmesartan, with a change in msSBP of -25.1 mm Hg versus -23.2 mm Hg with olmesartan. Sacubitril/allisartan 480 mg showed superior efficacy, reducing msSBP by -28.2 mm Hg compared to 20 mg olmesartan. Both doses of sacubitril/allisartan also effectively reduced 24-hour, daytime, and nighttime systolic and diastolic blood pressure, demonstrating dose-dependent effects.<br /><br />Safety assessments revealed that sacubitril/allisartan was well-tolerated with no cases of angioedema or death. Adverse events were comparable across all treatment groups, and most were mild or moderate.<br /><br />The study concluded that sacubitril/allisartan is an effective and well-tolerated treatment for hypertension, particularly beneficial in reducing nighttime blood pressure. This is significant for Asian populations who have higher salt intake and sensitivity, contributing to hypertension management. <br /><br />The findings support the potential of sacubitril/allisartan as a more effective alternative to current treatments, warranting further studies on its impact on cardiovascular events and long-term outcomes. <br /><br />Overall, sacubitril/allisartan offers a promising addition to hypertension therapy, particularly for patients requiring greater control over nocturnal blood pressure.

Keywords

sacubitril/allisartan

olmesartan

hypertension

Chinese patients

blood pressure

efficacy

safety

nighttime blood pressure

cardiovascular events

long-term outcomes