S-09-3: ROLE OF SACUBITRIL/VALSARTAN IN THE CONTROL OF BLOOD PRESSURE

Abstract

Sacubitril/valsartan an angiotensin receptor-neprilysin inhibitor has been shown to reduce the risk of cardiovascular risk death or heart failure hospitalization and improve symptoms among patients with chronic heart failure with reduced ejection fraction. The drug was born initially as an antihypertensive agent and showed an excellent capacity to decrease blood pressure superior to that of angiotensin receptor antagonists. Theoretically the combination seemed to be particularly suitable for difficult to control or resistant hypertension. Unfortunately the administration of sacubitril could translate into increased amyloid beta deposition albeit it was not fully confirmed. In fact John McMurray presented in the meeting of the European Society of Cardiology (25/aug/2022) the double blind trial PERSPECTIVE devoted to fully assess the long neurocognitive effects of sacubitril /valsartan versus valsartan that demonstrated that there was no difference in the cognitive capacity between the two groups of patients. These data permit to consider that the use of sacubitril/valsartan is not accompanied by relevant potential concerns. It opens then the use of this combination in hypertension that requires unlike heart failure longer periods of treatment. The clinical data available and the fact the the drug is being used in Japan in daily clinical prsctice facilitates the consideration of opening many other countries to the combination leading to a better control of blood pressure accompanied by simultaneous cardiorenal protection.