Effects of LCZ696 (Sacubitril/Valsartan) on Blood Pressure in Patients with Hypertension: A Meta-Analysis of Randomized Controlled Trials.

Background:LCZ696 (sacubitril/valsartan), a ?rst-in-class angiotensin receptor-neprilysin inhibitor, can significantly reduce blood pressure in patients with heart failure. We performed this meta-analysis to determine the antihypertensive effect of LCZ696 in patients with hypertension.Methods:Randomized controlled trials were searched in MEDLINE, the Cochrane Library, and Clinicaltrials.gov. Twelve studies with a total of 6,064 participants were included.Results:Compared with angiotensin receptor blockers (ARBs), LCZ696 100 mg caused a significant reduction in systolic blood pressure (SBP) (mean difference [MD] -1.58 mm Hg, 95% confidence interval [CI] -2.09 to -1.07,p< 0.05) and diastolic blood pressure (DBP) (MD -0.66 mm Hg, 95% CI -0.98 to -0.33,p< 0.05). LCZ696 200 mg caused a significant reduction in SBP (MD -4.94 mm Hg, 95% CI -6.54 to -3.35,p< 0.05), DBP (MD -2.24 mm Hg, 95% CI -2.74 to -1.75,p< 0.05), 24-h ambulatory SBP (24 h ASBP; MD -3.69 mm Hg, 95% CI -4.80 to -2.58,p< 0.05), and 24-h ADBP (MD -1.71 mm Hg, 95% CI -2.13 to -1.28,p< 0.05). LCZ696 400 mg caused a significant reduction in SBP (MD -6.25 mm Hg, 95% CI -7.90 to -4.61,p< 0.05), DBP (MD -2.30 mm Hg, 95% CI -2.80 to -1.80,p< 0.05), 24-h ASBP (MD -4.31 mm Hg, 95% CI -6.56 to -2.07,p< 0.05), and 24 h ADBP (MD -1.69 mm Hg, 95% CI -2.59 to -0.79,p< 0.05). Compared with LCZ696 200 mg, LCZ696 400 mg caused a significant reduction in SBP (MD 1.71 mm Hg, 95% CI 1.15 to 2.27,p< 0.05), DBP (MD 0.90 mm Hg, 95% CI 0.65 to 1.16,p< 0.05), 24-h ASBP (MD 1.50 mm Hg, 95% CI 0.84 to 2.17,p< 0.05), and 24-h ADBP (MD 0.76 mm Hg, 95% CI 0.47 to 1.06,p< 0.05).Conclusions:The blood pressure-lowering effect of LCZ696 is dose-related. This meta-analysis confirms the antihypertensive effects of LCZ696.