Abstract：
BACKGROUND: Since sacubitril/valsartan (LCZ696) has neprilysin inhibition and angiotensin receptor-blocking properties, it is anticipated to have strong antihypertensive effects. However, there is not enough evidence to compare the safety and efficacy of sacubitril/valsartan to those of olmesartan in patients with hypertension.
OBJECTIVE: To compare the efficacy and safety of sacubitril/valsartan versus olmesartan in patients with hypertension.
METHODS: This study follows the guidelines of the Cochrane Handbook. We searched MEDLINE, Cochrane Central, Scopus, and Web of Science databases for relevant clinical trials. We extracted outcome endpoints regarding mean ambulatory systolic/diastolic blood pressure (maSBP/maDBP), mean sitting systolic/diastolic blood pressure (msSBP/msDBP), mean ambulatory/mean sitting pulse pressure (maPP/msPP), the proportion of patients achieving blood pressure control (< 140/90 mmHg), and adverse events. We used Review Manager Software for the conduction of the analysis of this study. The effect estimates of the studies were pooled as Mean difference or risk ratio and 95% confidence interval. We also conducted a subgroup analysis based on the dose of sacubitril/valsartan.
RESULTS: A total of six clinical trials were included. The studies showed an overall low risk of bias. The pooled effect estimate revealed that sacubitril/valsartan significantly reduces maSBP, maDBP, maPP, msSBP, and msDBP measurements compared with olmesartan (p < 0.001). A significantly higher portion of patients achieved blood pressure control in the sacubitril/valsartan group (p < 0.001). The test of subgroup difference showed that 400 mg dose is significantly more effective than 200 mg dose in reducing maSBP. Regarding the safety profile, olmesartan was associated with more side effects due to drug discontinuation and more serious side effects.
CONCLUSIONS: Sacubitril/valsartan or LCZ696 is more effective and safer than olmesartan for controlling blood pressure in patients with hypertension.
OBJECTIVE: To compare the efficacy and safety of sacubitril/valsartan versus olmesartan in patients with hypertension.
METHODS: This study follows the guidelines of the Cochrane Handbook. We searched MEDLINE, Cochrane Central, Scopus, and Web of Science databases for relevant clinical trials. We extracted outcome endpoints regarding mean ambulatory systolic/diastolic blood pressure (maSBP/maDBP), mean sitting systolic/diastolic blood pressure (msSBP/msDBP), mean ambulatory/mean sitting pulse pressure (maPP/msPP), the proportion of patients achieving blood pressure control (< 140/90 mmHg), and adverse events. We used Review Manager Software for the conduction of the analysis of this study. The effect estimates of the studies were pooled as Mean difference or risk ratio and 95% confidence interval. We also conducted a subgroup analysis based on the dose of sacubitril/valsartan.
RESULTS: A total of six clinical trials were included. The studies showed an overall low risk of bias. The pooled effect estimate revealed that sacubitril/valsartan significantly reduces maSBP, maDBP, maPP, msSBP, and msDBP measurements compared with olmesartan (p < 0.001). A significantly higher portion of patients achieved blood pressure control in the sacubitril/valsartan group (p < 0.001). The test of subgroup difference showed that 400 mg dose is significantly more effective than 200 mg dose in reducing maSBP. Regarding the safety profile, olmesartan was associated with more side effects due to drug discontinuation and more serious side effects.
CONCLUSIONS: Sacubitril/valsartan or LCZ696 is more effective and safer than olmesartan for controlling blood pressure in patients with hypertension.
摘要：
背景：由于沙库巴曲/缬沙坦（LCZ696）具有脑啡肽抑制和血管紧张素受体阻断特性，预计具有很强的抗高血压作用。然而,没有足够的证据比较沙库巴曲/缬沙坦与奥美沙坦在高血压患者中的安全性和有效性.
目的：比较沙库巴曲/缬沙坦与奥美沙坦治疗高血压的疗效和安全性。
方法：本研究遵循Cochrane手册的指导原则。我们搜索了MEDLINE,CochraneCentral,Scopus,和相关临床试验的WebofScience数据库。我们提取了关于平均动态收缩压/舒张压（maSBP/maDBP）的结局终点，平均坐位收缩压/舒张压（msSBP/msDBP），平均动态/平均坐位脉压（maPP/msPP），实现血压控制（<140/90mmHg）的患者比例，和不良事件。我们使用ReviewManager软件进行本研究的分析。将研究的效果估计合并为平均差或风险比和95％置信区间。我们还根据沙库巴曲/缬沙坦的剂量进行了亚组分析。
结果：共纳入6项临床试验。研究显示总体上偏倚的风险较低。汇总效应估计显示沙库巴曲/缬沙坦显着降低maSBP，maDBP,maPP,msSBP,和msDBP测量值与奥美沙坦相比（p<0.001）。沙库必曲/缬沙坦组患者血压控制明显较高（p<0.001）。亚组差异测试表明，400mg剂量比200mg剂量在降低maSBP方面明显更有效。关于安全性,奥美沙坦因停药和更严重的副作用而产生更多副作用。
结论：Sacubitril/缬沙坦或LCZ696比奥美沙坦更有效，更安全地控制高血压患者的血压。
目的：比较沙库巴曲/缬沙坦与奥美沙坦治疗高血压的疗效和安全性。
方法：本研究遵循Cochrane手册的指导原则。我们搜索了MEDLINE,CochraneCentral,Scopus,和相关临床试验的WebofScience数据库。我们提取了关于平均动态收缩压/舒张压（maSBP/maDBP）的结局终点，平均坐位收缩压/舒张压（msSBP/msDBP），平均动态/平均坐位脉压（maPP/msPP），实现血压控制（<140/90mmHg）的患者比例，和不良事件。我们使用ReviewManager软件进行本研究的分析。将研究的效果估计合并为平均差或风险比和95％置信区间。我们还根据沙库巴曲/缬沙坦的剂量进行了亚组分析。
结果：共纳入6项临床试验。研究显示总体上偏倚的风险较低。汇总效应估计显示沙库巴曲/缬沙坦显着降低maSBP，maDBP,maPP,msSBP,和msDBP测量值与奥美沙坦相比（p<0.001）。沙库必曲/缬沙坦组患者血压控制明显较高（p<0.001）。亚组差异测试表明，400mg剂量比200mg剂量在降低maSBP方面明显更有效。关于安全性,奥美沙坦因停药和更严重的副作用而产生更多副作用。
结论：Sacubitril/缬沙坦或LCZ696比奥美沙坦更有效，更安全地控制高血压患者的血压。
