PDF(Pubmed)
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. Methods and 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.
摘要：
背景：沙库巴曲/缬沙坦（Sac/Val）的降血压作用大于血管紧张素II受体阻滞剂（ARB），但在现实世界的临床实践中，Sac/Val用于除从ARB切换之外的各种模式中。在本研究中，我们研究了Sac/Val在将其从或添加到各种抗高血压药物中时对BP和生化参数的影响，并研究了哪些因素可能是Sac/Val抗高血压作用的预测因素。方法和结果：108例高血压患者接受抗高血压药物治疗（包括4例未治疗），在切换/添加Sac/Val(200mg/day)之前和之后评估临床BP和各种生化参数.Sac/Val治疗后收缩和舒张BPs显著降低(P分别<0.0001)。至于生化参数，丙氨酸氨基转移酶，甘油三酯，C反应蛋白,服用Sac/Val后尿酸显着降低，但肾功能,B型利钠肽,血浆肾素活性（PRA）在Sac/Val治疗前后均无变化。多元回归分析显示，低PRA和高基线收缩压是Sac/Val治疗后收缩压降低的独立决定因素。结论：在日常临床实践中，Sac/Val对控制不佳的高血压有益，低PRA可能是转换/添加Sac/Val的降压效果的预测因子。
