沙库巴曲缬沙坦在难治性高血压患者中的研究进展

Research Progress of Sacubitril/Valsartan in the Treatment of Patients with Resistant Hypertension

难治性高血压以盐敏感性增加引起的夜间血压升高为主要特征,是心血管不良事件的主要可控危险因素之一,其治疗目前依旧是一个具有挑战性的临床问题。沙库巴曲缬沙坦(LCZ696)是一种新型的血管紧张素受体脑啡肽酶抑制剂,其在降压及逆转心室重塑中的优势已被证实。此外,相比于白天血压,其对夜间血压改善更为显著。因此,结合先前研究我们考虑LCZ696可能是一种治疗难治性高血压的潜在有效药物,不仅可以用于难治性高血压的二级预防,还可能有效延缓难治性高血压向心衰的进展。现就LCZ696药理作用及其在高血压尤其是难治性高血压中的应用进行综述,以期为难治性高血压的治疗提供新的临床思路。

Resistant hypertension (RHTN), characterized by increased nocturnal blood pressure (BP) induced by elevated salt sensitivity, is a significant controllable risk factor for adverse cardiovascular events. The treatment of RHTN is still a challenging clinical problem. Sacubitril/valsartan (LCZ696), an an-giotensin receptor neprilysin inhibitor, has been demonstrated to effectively reduce BP and reverse ventricular remodeling. Besides, the decrease in nocturnal BP caused by LCZ696 was more signifi-cant than that of daytime BP. Thus, based on previous research, we propose that LCZ696 could be a potentially effective drug for RHTN, which may not only be used as the secondary prevention of RHTN, but also slow the progression from RHTN to heart failure. This review describes the pharma-cological effects of LCZ696 and gives an overview of its application in the treatment of hypertension especially in RHTN in order to provide a new clinical idea for the treatment of RHTN.