Sacubitril–valsartan as a treatment for apparent resistant hypertension in patients with heart failure and preserved ejection fraction
Post hoc analysis of the PARAGON-HF trial (n=4,795) found sacubitril/valsartan was more effective than valsartan alone for achieving controlled systolic blood pressure in those with resistant hypertension at study entry (47.9% vs 34.3%, OR 1.78, 95%CI 1.30-2.43).
Source:
European Heart Journal
SPS commentary:
A related commentary discusses this research and highlights the pathophysiological link between uncontrolled hypertension and heart failure with preserved ejection fraction (HFpEF). It states these new data suggest sacubitril/valsartan may represent a rational and viable therapeutic strategy in the management of resistant hypertension in HFpEF patients, even though specifically designed randomised clinical trials are required to support this indication. It would be interesting to explore in future studies whether the use of sacubitril/valsartan in subjects with resistant hypertension may delay or prevent the development of hypertension-mediated cardiac damage and the progression to HFpEF.