1. Efficacy and Safety of Sacubitril/Valsartan in Chronic Type B Aortic Dissection Combined With Mild Hypertension.
- Author
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Wang X, Song F, Jiang L, Huang Z, Luo S, Li X, and He X
- Subjects
- Humans, Male, Middle Aged, Female, Treatment Outcome, Aged, Chronic Disease, Angiotensin Receptor Antagonists therapeutic use, Angiotensin Receptor Antagonists adverse effects, Tetrazoles therapeutic use, Tetrazoles adverse effects, Aortic Aneurysm drug therapy, China epidemiology, Time Factors, Angiotensin II Type 1 Receptor Blockers therapeutic use, Angiotensin II Type 1 Receptor Blockers adverse effects, Valsartan therapeutic use, Aminobutyrates therapeutic use, Aminobutyrates adverse effects, Drug Combinations, Biphenyl Compounds, Hypertension drug therapy, Hypertension physiopathology, Hypertension diagnosis, Aortic Dissection physiopathology, Aortic Dissection drug therapy, Blood Pressure drug effects, Antihypertensive Agents therapeutic use, Antihypertensive Agents adverse effects
- Abstract
Background: Optimal antihypertensive medication for chronic type B aortic dissection (AD) remains undecided. This study compared the efficacy and safety of sacubitril/valsartan with valsartan to determine suitable antihypertensive drug combinations., Methods: In this single-center, open-label, randomized, controlled trial, patients with chronic Stanford type B AD and mild hypertension were randomized to receive sacubitril/valsartan 100/200 mg or valsartan 80/160 mg. The primary endpoint was the reduction in mean sitting systolic blood pressure (msSBP) at week 8 in patients with sacubitril/valsartan vs. valsartan. Key secondary endpoints included changes in (i) mean sitting diastolic blood pressure (msDBP); (ii) pulse pressure (PP); and (iii) mean ambulatory blood pressure (BP) for 24-hour, daytime, and nighttime. Safety assessments included adverse events (AEs) and serious AEs. This trial was registered with the Chinese Clinical Trial Registry, identifier: ChiCTR2300073399., Results: A total of 315 patients completed the study. Sacubitril/valsartan provided a significantly greater reduction in msSBP than valsartan at week 8 (between-treatment difference: -5.1 mm Hg [95% confidence interval -5.8 to -4.5], P < 0.001). Reductions in msSBP, msDBP, and PP as well as the mean ambulatory BP for 24-hour, daytime, and nighttime, were significantly greater in sacubitril/valsartan compared with valsartan (all P < 0.001). No excessive episodes of AEs occurred in the sacubitril/valsartan group., Conclusions: Sacubitril/valsartan and valsartan reduced BP compared with baseline values. However, sacubitril/valsartan improved BP control to a greater extent than valsartan. It may offer a new treatment option for patients with mild hypertension and chronic type B AD., (© The Author(s) 2024. Published by Oxford University Press on behalf of American Journal of Hypertension, Ltd. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2024
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