Efficacy of angiotensin receptor neprilysin inhibitor in Asian patients with refractory hypertension

Abstract

Abstract Background Angiotensin receptor neprilysin inhibitor, concomitantly inhibits neprilysin and angiotensin type 1 receptor shown an effect of reducing blood pressure. We aimed to study whether it can be used as an antihypertensive agent in patients with resistant hypertension who has already been treated. Methods This is a multiple center prospective study. Thirty-five Chinese patients with refractory hypertension were enrolled. Resistant hypertension was defined as on the basis of improved lifestyle when the application of the three reasonable and tolerable dose of antihypertensive drugs including thiazide diuretics at least four weeks after treatment, the inadequate control of BP is confirmed by ambulatory BP monitoring, or at least four drugs are needed to achieve the BP standard. Refractory hypertensive patient received sacubitil/valsartan 200 mg instead of their angiotensin type 1 receptor blocker while other agents were continued. If blood pressure was uncontrolled, the sacubitil/valsartan dose was increased to 400 mg after 4 weeks. ABPM were evaluated at 8 weeks follow up. Results Reductions in office SBP/DBP at week 8 were 37/17 mmHg. the average baseline ABPM were 154/90 mmHg of 24-h, and daytime BP and nighttime BP were 157/92 mmHg and 145/83 mmHg respectively. he average endpoint ABPM were 134/80 mmHg of 24-h, and daytime BP and nighttime BP were 136/82 mmHg and 125/73 mmHg respectively. Reductions in 24-h ABPM at week 8 were 20/9 mmHg while 20/10 mmHg in daytime and 20/9 mmHg in nighttime. Conclusion The sacubitil/valsartan provided a strategy therapy for refractory hypertension in Chinese patients in reducing SBP and DBP. Funding Acknowledgement Type of funding sources: None.