open access

Vol 21, No 2 (2017)
REVIEW
Published online: 2017-06-30
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Sacubitril/valsartan in therapy of hypertension

Jerzy Głuszek, Teresa Maria Kosicka
DOI: 10.5603/AH.2017.0013
·
Arterial Hypertension 2017;21(2):99-104.

open access

Vol 21, No 2 (2017)
REVIEW
Published online: 2017-06-30

Abstract

In recent years a new very promising drug was introduced for the treatment of chronic heart failure. This drug, sacubitril/valsartan, prevents the clinical progression of surviving patients with heart failure more effectively than enalapril and it reduces the need for hospitalization by more than 20%. At the same time it has been shown that it reduces blood pressure particularly in patients with essential hypertension. This drug is an inhibitor of neprilysin, an enzyme that degrades natriuretic factors. Natriuretic factors (ANP, BNP, CNP) increase diuresis and natriuresis, reduce the activity of the sympathetic system, relax the blood vessels and inhibit fibrosis. Several studies have shown that sacubitril/valsartan therapy more significantly reduces blood pressure in patients with salt-sensitive or refractory to treatment hypertension than is observed with valsartan or amlodipine. Furthermore, beneficial effects of this drug on central blood pressure and renal function have been demonstrated in patients with chronic renal failure. More rarely than enalapril it leads to hyperkalaemia in patients treated simultaneously with mineralocorticoid receptor inhibitors. Sacubitril/valsartan is the first representative of a new class of drugs that inhibit neprilysin, which probably in the future will be frequently used in hypertension.

Abstract

In recent years a new very promising drug was introduced for the treatment of chronic heart failure. This drug, sacubitril/valsartan, prevents the clinical progression of surviving patients with heart failure more effectively than enalapril and it reduces the need for hospitalization by more than 20%. At the same time it has been shown that it reduces blood pressure particularly in patients with essential hypertension. This drug is an inhibitor of neprilysin, an enzyme that degrades natriuretic factors. Natriuretic factors (ANP, BNP, CNP) increase diuresis and natriuresis, reduce the activity of the sympathetic system, relax the blood vessels and inhibit fibrosis. Several studies have shown that sacubitril/valsartan therapy more significantly reduces blood pressure in patients with salt-sensitive or refractory to treatment hypertension than is observed with valsartan or amlodipine. Furthermore, beneficial effects of this drug on central blood pressure and renal function have been demonstrated in patients with chronic renal failure. More rarely than enalapril it leads to hyperkalaemia in patients treated simultaneously with mineralocorticoid receptor inhibitors. Sacubitril/valsartan is the first representative of a new class of drugs that inhibit neprilysin, which probably in the future will be frequently used in hypertension.

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Keywords

hypertension, natriuretic factors, sacubitril/valsartan

About this article
Title

Sacubitril/valsartan in therapy of hypertension

Journal

Arterial Hypertension

Issue

Vol 21, No 2 (2017)

Pages

99-104

Published online

2017-06-30

DOI

10.5603/AH.2017.0013

Bibliographic record

Arterial Hypertension 2017;21(2):99-104.

Keywords

hypertension
natriuretic factors
sacubitril/valsartan

Authors

Jerzy Głuszek
Teresa Maria Kosicka

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