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The Effects of Sacubitril/Valsartan Compared to Olmesartan on the Blood Pressure and Glucolipid Metabolism in DM Patients with Primary Hypertension

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Abstract

Purpose

Given the beneficial effects of sacubitril/valsartan on blood pressure generally, this study investigates its antihypertension effects in diabetes mellitus (DM) patients with primary hypertension specifically, and the effect of sacubitril/valsartan on glycolipid metabolism.

Methods

We conducted a randomized, open-label, active-controlled study to compare the antihypertension effects of sacubitril/valsartan in DM individuals with primary hypertension. The primary end point was reduction in mean systolic blood pressure (SBP) from baseline with sacubitril/valsartan vs. olmesartan at week 8. The secondary endpoints included the changes in diastolic blood pressure (DBP), daytime SBP/DBP, nighttime SBP/DBP, BP achievement (office sitting BP < 130/80 mmHg), and lipid profile. The trial was registered with chictr.org.cn (ChiCTR2200066428) on Dec 22, 2022.

Results

A total of 124 patients were included in the final analysis. SBP decreased to a greater extent in the sacubitril/valsartan group from baseline to 8 weeks [between-treatment difference: 3.51 mm Hg, 95% confidence interval (95% CI) 0.41 to 6.62 mm Hg, P = 0.03]. Furthermore, more patients achieved the blood pressure goal with sacubitril/valasartan (74.60% vs. 54.70%, P = 0.03). Multiple logistical regression analysis showed that sacubitril/valsartan was associated with BP achievement [odds ratio (OR) 0.33, 95% CI 0.14–0.73, P = 0.007], but the difference in SBP, DBP, day time SBP/DBP, and night time SBP/DBP reduction did not approach statistical significance. HbA1C1, total cholesterol, and low-density lipoprotein-cholesterol were lower than baseline in both groups (P < 0.05); however, there was no difference in the effects on glucose and lipid metabolism from sacubitril/valsartan compared to olmesartan.

Conclusions

Sacubitril/valsartan not only provided superior BP reduction compared to olmesartan, it did so without adverse effects on glycemic control and lipid parameters in DM patients with primary hypertension.

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Data Availability

Not applicable.

Code Availability

The codes used in the analyses can be made available by the corresponding author on request.

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Funding

This research was funded by Cardiovascular Health Alliance Nuo-Chuang Hypertension Research and Innovation Fund (2021-CCA-HTN-10).

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Authors and Affiliations

  1. Cardiometabolic Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Science and Peking Union Medical College, No 167 BeiLiShi Road, XiCheng District, Beijing, 100037, China

    Shuang Zhang, Zheng Yin, Zhi-Fan Li, Wen-Jia Zhang, Yong-Gang Sui, Yan-Lu Xu, Hai-Tao Zhang, Xiao-Ning Liu, Hong Qiu, Jing-Lin Zhao, Jian-Jun Li, Ke-Fei Dou, Jie Qian & Na-Qiong Wu

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  1. Shuang Zhang
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Contributions

N.-Q.W.: conception/design. W.-J.Z., Y.-G.S., Y.-L.X., H.-T.Z., X.-N.L., H.Q., J.-L.Z., J.-J.L., K.-F.D., and J.Q.: provision of study materials. S.Z., Z.Y., and Z.-F.L.: collection and/or assembly of data. S.Z.: data analysis, interpretation, and manuscript writing. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Na-Qiong Wu.

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The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Fuwai Hospital.

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Zhang, S., Yin, Z., Li, ZF. et al. The Effects of Sacubitril/Valsartan Compared to Olmesartan on the Blood Pressure and Glucolipid Metabolism in DM Patients with Primary Hypertension. Cardiovasc Drugs Ther (2023). https://doi.org/10.1007/s10557-023-07509-1

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