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Different Doses of Sacubitril/Valsartan Compared with Olmesartan in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis

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A Correction to this article was published on 31 May 2023

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Abstract

Introduction

Since sacubitril/valsartan (LCZ696) has neprilysin inhibition and angiotensin receptor-blocking properties, it is anticipated to have strong antihypertensive effects. However, there is not enough evidence to compare the safety and efficacy of sacubitril/valsartan to those of olmesartan in patients with hypertension.

Aim

To compare the efficacy and safety of sacubitril/valsartan versus olmesartan in patients with hypertension.

Methods

This study follows the guidelines of the Cochrane Handbook. We searched MEDLINE, Cochrane Central, Scopus, and Web of Science databases for relevant clinical trials. We extracted outcome endpoints regarding mean ambulatory systolic/diastolic blood pressure (maSBP/maDBP), mean sitting systolic/diastolic blood pressure (msSBP/msDBP), mean ambulatory/mean sitting pulse pressure (maPP/msPP), the proportion of patients achieving blood pressure control (< 140/90 mmHg), and adverse events. We used Review Manager Software for the conduction of the analysis of this study. The effect estimates of the studies were pooled as Mean difference or risk ratio and 95% confidence interval. We also conducted a subgroup analysis based on the dose of sacubitril/valsartan.

Results

A total of six clinical trials were included. The studies showed an overall low risk of bias. The pooled effect estimate revealed that sacubitril/valsartan significantly reduces maSBP, maDBP, maPP, msSBP, and msDBP measurements compared with olmesartan (p < 0.001). A significantly higher portion of patients achieved blood pressure control in the sacubitril/valsartan group (p < 0.001). The test of subgroup difference showed that 400 mg dose is significantly more effective than 200 mg dose in reducing maSBP. Regarding the safety profile, olmesartan was associated with more side effects due to drug discontinuation and more serious side effects.

Conclusion

Sacubitril/valsartan or LCZ696 is more effective and safer than olmesartan for controlling blood pressure in patients with hypertension.

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Authors and Affiliations

  1. Department of Internal Medicine, Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia

    Amjaad Ibrahim Almarjan

  2. Department of Pharmaceutical Services, Al Kharj Military Hospitals, Al Kharj, Saudi Arabia

    Sara Abdulaziz Almarjan

  3. Faculty of Medicine, Fayoum University, 21 Mesalla St., Dalla, Faiyum, 63525, Egypt

    Ahmed Taher Masoud

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  1. Amjaad Ibrahim Almarjan
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Correspondence to Ahmed Taher Masoud.

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The original article has been updated: Due to title change.

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Almarjan, A.I., Almarjan, S.A. & Masoud, A.T. Different Doses of Sacubitril/Valsartan Compared with Olmesartan in Patients with Essential Hypertension: A Systematic Review and Meta-Analysis. High Blood Press Cardiovasc Prev 30, 207–218 (2023). https://doi.org/10.1007/s40292-023-00572-7

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