Potential Effects of Sacubitril/Valsartan on the Cardio-ankle Vascular Index in Hypertensive Patients

Objective Angiotensin receptor-neprilysin inhibitors (ARNIs) have been widely used as a treatment for heart failure. However, they have only been approved for the treatment of hypertension in a limited number of countries. We investigated the effect of ARNIs on arterial stiffness using the cardio-ankle vascular index (CAVI) in patients with hypertension to reveal the mechanism underlying cardiovascular interaction. Methods We investigated the utility of ARNIs in patients in whom arterial stiffness was assessed using the CAVI before and after ARNI administration. Patients In this retrospective observational study, we enrolled 50 patients with hypertension treated with ARNIs between January 2021 and 2023. Forty-eight of the 50 patients (96%) were switched from angiotensin II receptor blockers due to inadequate antihypertensive control. Results The systolic blood pressure (BP), diastolic BP, and CAVI were significantly decreased by ARNI administration [systolic BP: 145 (135, 162) to 131 (123, 143) mmHg (p=0.000); diastolic BP: 92 (78, 100) to 82 (74, 89) mmHg (p=0.000); and CAVI: 9.9 (9.1, 10.5) to 9.5 (8.8, 10.2) (p=0.005), respectively]. Conclusion Hypertension treatment with ARNIs may improve not only the blood pressure but also the CAVI, reducing the afterload on the heart.