Efficacy and Safety of Sacubitril/Valsartan After Switching From Azilsartan in Essential Hypertensive Patients: Based on Home Blood Pressure Monitoring

This study assessed the efficacy and safety of sacubitril/valsartan in 27 essential hypertensive patients (mean age 74 years; male 48.1%) after switching from azilsartan, an angiotensin receptor blocker. At baseline and 3 and 6 months after the start of sacubitril/valsartan treatment, home blood pressure (HBP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were measured. The mean dosage of azilsartan was 27±10 mg/day at baseline and that of sacubitril/valsartan after 6 months of treatment was 170±47 mg/day. After 6 months, significant reductions in mean morning HBP (144 ± 13/77 ± 13 to 128 ± 10/71 ± 9 mmHg) and median (IQR) NT-proBNP level (188.2 [85.3-887.3] to 124.0 [83.6-696.2] pg/mL) were observed. Twenty-one out of 27 patients accomplished recording of their nighttime HBP, and the morning-nighttime difference in systolic HBP was decreased (8.8 ± 13.5 to 3.9 ± 8.5 mmHg)(all p < 0.05 by repeated-measures ANOVA). In hypertensive patients, sacubitril/valsartan was generally well tolerated, except for causing hypotension, effectively controlled out-of-office BP, and decreased NT-proBNP.