Why the study?
Does sacubitril/valsartan reduce ambulatory systolic BP in patients with mild to moderate essential hypertension uncontrolled by olmesartan?
Does sacubitril/valsartan reduce ambulatory systolic BP in patients with mild to moderate essential hypertension uncontrolled by olmesartan?
Sacubitril/valsartan 200 mg provides superior blood pressure reduction compared to continuing olmesartan 20 mg in patients with mild to moderate essential hypertension uncontrolled on olmesartan alone.
Supports switching to sacubitril/valsartan for superior ambulatory SBP control; extends ARNI evidence in essential hypertension.
A majority of patients with hypertension fail to achieve blood pressure (BP) control despite treatment with commonly prescribed drugs. This randomized, double-blind phase III trial assessed the superiority of sacubitril/valsartan 200 mg (97/103 mg) to continued olmesartan 20 mg in reducing ambulatory systolic BP after 8-week treatment in patients with mild to moderate essential hypertension uncontrolled with olmesartan 20 mg alone. A total of 376 patients were randomized to receive either sacubitril/valsartan (n = 188) or olmesartan (n = 188). Superior reductions in 24-hour mean ambulatory systolic BP were observed in the sacubitril/valsartan group vs the olmesartan group (-4.3 mm Hg vs -1.1 mm Hg, P < .001). Reductions in 24-hour mean ambulatory diastolic BP and pulse pressure and office systolic BP and diastolic BP were significantly greater with sacubitril/valsartan vs olmesartan (P < .014). A greater proportion of patients achieved BP control with sacubitril/valsartan vs olmesartan. The overall incidence of adverse events was comparable between the groups. Compared with continued olmesartan, sacubitril/valsartan was more effective and generally safe in patients with hypertension uncontrolled with olmesartan 20 mg.
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Cheung et al. (2018) studied this question.
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