Sacubitril/valsartan outdoes standard therapy in patients with resistant hypertension

Combination treatment with sacubitril and valsartan demonstrates greater efficacy than standard therapy in achieving blood pressure (BP) control and BP reduction in Afro-descendant patients with resistant hypertension, reports a study.

The proportion of patients who achieved BP control was significantly greater in the sacubitril/valsartan group than in the control group (94.9 percent vs 69.2 percent; p=0.03). Additionally, the study treatment resulted in a significant reduction in mean sitting pulse pressure (PP; –6.05 mm Hg; p=0.008) and exhibited a trend toward greater reduction in mean sitting systolic BP (p=0.06).

Notably, BP reduction was highest with the 400-mg dose, particularly for mean sitting PP (p=0.034). None of the participants died.

“Sacubitril/valsartan was more effective than standard therapy in achieving BP control and reducing BP in resistant hypertension, with a dose-dependent trend favouring the 400-mg regimen,” the researchers said. “These findings support sacubitril-valsartan as a potential treatment alternative for high-risk Afro-descendant patients.”

Eighty adults with resistant hypertension participated in this phase III, 8-week, single-centre, randomized trial. They were assigned to sacubitril/valsartan (titrated to 200 mg with an optional increase to 400 mg if BP remained >140/90 mm Hg) or standard therapy (ARB/ACEI combined with other antihypertensive agents).

The primary endpoint was the proportion of patients achieving BP control (<140/90 mm Hg), and the coprimary endpoints included mean reductions in mean sitting PP, mean sitting diastolic BP, and mean sitting systolic BP at week 8. Dose-dependent BP decease was assessed as a secondary outcome.