Difference of hypotensive effect of sarcubitril / valsartan between hypertensive patients with increased and with normal left atrial diameter

Objective To observe the difference of hypotensive effect of sarcubitril/valsartan between hypertensive patients with increased left atrial diameter (LAD) and with normal LAD. Methods A total of 80 patients who were diagnosed as essential hypertension in Nanjing First Hospital from June 2021 to January 2022 were selected, and they all did not take antihypertensive drugs in the past two weeks. According to the size of LAD, they were divided into first group (LAD≥40 mm, n=50) and second group (LAD＜40 mm, n=30) . After enrollment, all patients were given a daily dose of 100 mg of sarcubitril/valsartan. If the blood pressure reached the standard after 1 week［systolic blood pressure (SBP) ＜140 mmHg and diastolic blood pressure (DBP) ＜90 mmHg］, continue to use 100 mg of sarcubitril/valsartan. If not, increase the dose to 200 mg of sarcubitril/valsartan per day. If the blood pressure reaches the standard after 2 weeks, continue to use 200 mg dose. If the blood pressure does not reach the standard, add it to 400 mg dose per day or add other kinds of antihypertensive drugs according to the patient's individualized situation. The changes of blood pressure level and the rate of reaching the standard of blood pressure in the two groups for 4 weeks (28th day) were observed and compared. Results Compared with second group, the decrease of SBP ［7th day: (11.06±1.36) mmHg vs (7.53±1.31) mmHg, P＜0.01; 14th day: (19.70±2.62) mmHg vs (13.80±1.92) mmHg, P＜0.01］ and the decrease of DBP ［7th day: (5.76±2.63) mmHg vs (4.47±1.31) mmHg, P=0.014; 14th day: (10.02±3.17) mmHg vs (8.23±2.84) mmHg, P=0.013］ were significant higher in the first group. After four weeks, there was no significant difference in SBP, DBP levels and the distribution of proportion of combined use of antihypertensive drugs between the two groups (P＞0.05) . Conclusion Compared with hypertensive patients with normal LAD, sarcubitril/valsartan has a better effect on blood pressure reduction in patients with increased LAD is more superior, and the blood pressure reduction range is very obvious in the first two weeks after use.