PMID- 36326841
OWN - NLM
STAT- MEDLINE
DCOM- 20230628
LR  - 20230701
IS  - 1861-0692 (Electronic)
IS  - 1861-0684 (Print)
IS  - 1861-0684 (Linking)
VI  - 112
IP  - 7
DP  - 2023 Jul
TI  - Network meta-analysis of sacubitril/valsartan for the treatment of essential 
      hypertension.
PG  - 855-867
LID - 10.1007/s00392-022-02120-0 [doi]
AB  - AIM: Sacubitril/valsartan has been demonstrated to reduce blood pressure in 
      hypertensive patients, but the best dose remains unclear. We performed this 
      network meta-analysis to determine the comparative efficacy and safety of three 
      available doses of sacubitril/valsartan (i.e., 100, 200, and 400 mg). METHODS AND 
      RESULTS: We searched four databases for relevant studies published before January 
      2022. Mean systolic and diastolic blood pressures in the sitting position (msSBP 
      and msDBP) and ambulatory condition (24-h maSBP and maDBP) and adverse events 
      (AEs) were assessed. Nine randomized controlled trials (RCTs) involving 5474 
      patients were included. Sacubitril/valsartan 200 mg once daily was slightly 
      better than 400 mg once daily in lowering 24-h maDBP (MD, 1.31 mmHg; 95% CI 
      0.61-2.01 mmHg), slightly better than 100 mg once daily in lowering 24-h maSBP 
      (MD, - 3.70 mmHg; 95% CI  - 6.22 to - 1.18 mmHg) and 24-h maDBP (MD, - 2.98; 95% 
      CI - 5.11 to - 0.85), and slightly better than Valsartan 160 mg once daily in 
      lowering 24-h maSBP (MD, - 3.23 mmHg; 95% CI, - 5.25 to - 1.21). 400 mg once 
      daily of sacubitril/valsartan was better than 200 mg once daily in lowering msDBP 
      (MD, - 9.38 mmHg; 95% CI - 17.79 to - 0.97 mmHg). Interestingly, 400 mg once 
      daily of sacubitril/valsartan had fewer trial-specified AEs than 200 mg once 
      daily (OR, 0.74; 95%CI 0.55-0.99). There was no statistical difference for the 
      remaining comparisons. CONCLUSIONS: In hypertensive patients, 200 mg once daily 
      of sacubitril/valsartan may exert a greater reduction in ambulatory blood 
      pressure than 100 mg once daily and 200 mg once daily may not be inferior to 
      400 mg once daily. Moreover, it is not clear that sacubitril/valsartan lowers 
      blood pressure more than an angiotensin receptor blocker. Further trials are 
      required to determine the incremental value of sacubitril/valsartan as an 
      anti-hypertensive agent.
CI  - (c) 2022. The Author(s).
FAU - Zhang, Yaling
AU  - Zhang Y
AD  - Department of Nephrology, Sichuan Provincial People's Hospital, University of 
      Electronic Science and Technology of China, Chengdu, 610072, China.
FAU - Zhao, Xiaoyu
AU  - Zhao X
AD  - Department of Cardiovascular, Sichuan Provincial People's Hospital, University of 
      Electronic Science and Technology of China, Chengdu, 610072, China.
FAU - Huang, Hao
AU  - Huang H
AD  - Department of Cardiovascular, Sichuan Provincial People's Hospital, University of 
      Electronic Science and Technology of China, Chengdu, 610072, China. 
      howardsc@foxmail.com.
FAU - Li, Ming
AU  - Li M
AD  - Department of Cardiovascular, Sichuan Provincial People's Hospital, University of 
      Electronic Science and Technology of China, Chengdu, 610072, China. 
      lmjy4788@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
DEP - 20221103
PL  - Germany
TA  - Clin Res Cardiol
JT  - Clinical research in cardiology : official journal of the German Cardiac Society
JID - 101264123
RN  - 17ERJ0MKGI (sacubitril)
RN  - 0 (Angiotensin II Type 1 Receptor Blockers)
RN  - 0 (Tetrazoles)
RN  - 80M03YXJ7I (Valsartan)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Drug Combinations)
RN  - 0 (Angiotensin Receptor Antagonists)
SB  - IM
MH  - Humans
MH  - Network Meta-Analysis
MH  - *Angiotensin II Type 1 Receptor Blockers/therapeutic use
MH  - Tetrazoles/adverse effects
MH  - Valsartan/pharmacology
MH  - *Hypertension/diagnosis/drug therapy
MH  - Essential Hypertension/chemically induced/drug therapy
MH  - Antihypertensive Agents/therapeutic use
MH  - Blood Pressure
MH  - Drug Combinations
MH  - Angiotensin Receptor Antagonists/adverse effects
MH  - Randomized Controlled Trials as Topic
PMC - PMC10293449
OTO - NOTNLM
OT  - Diastolic blood pressure
OT  - Hypertension
OT  - Network meta-analysis
OT  - Sacubitril/valsartan
OT  - Systolic blood pressure
COIS- The authors have no relevant financial or non-financial interests to disclose.
EDAT- 2022/11/04 06:00
MHDA- 2023/06/28 06:42
PMCR- 2022/11/03
CRDT- 2022/11/03 12:12
PHST- 2022/04/27 00:00 [received]
PHST- 2022/10/19 00:00 [accepted]
PHST- 2023/06/28 06:42 [medline]
PHST- 2022/11/04 06:00 [pubmed]
PHST- 2022/11/03 12:12 [entrez]
PHST- 2022/11/03 00:00 [pmc-release]
AID - 10.1007/s00392-022-02120-0 [pii]
AID - 2120 [pii]
AID - 10.1007/s00392-022-02120-0 [doi]
PST - ppublish
SO  - Clin Res Cardiol. 2023 Jul;112(7):855-867. doi: 10.1007/s00392-022-02120-0. Epub 
      2022 Nov 3.