Serum uric acid-lowering effect of sacubitril/valsartan in hypertensive patients: evaluation by switching from angiotensin II receptor blockers.

IF 1.2 4区医学 Q4 PERIPHERAL VASCULAR DISEASE

Blood Pressure Monitoring Pub Date : 2024-12-01 Epub Date: 2024-09-18 DOI:10.1097/MBP.0000000000000725

Takeshi Horio, Yoshio Iwashima, Minoru Yoshiyama, Daiju Fukuda, Takamasa Hasegawa, Kohei Fujimoto

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引用次数: 0

Abstract

Objective: Since hyperuricemia is a risk factor for cardiovascular disease and chronic kidney disease, it is necessary to pay attention to trends in uric acid levels when treating hypertensive patients with drugs. The present study investigated the effect of switching from angiotensin II receptor blocker (ARB) to sacubitril/valsartan on serum uric acid levels in treated hypertensive patients and further examined what factors could be associated with its effect.

Methods: In 75 hypertensive patients under treatment with at least one antihypertensive agent including ARB, clinic blood pressure and biochemical parameters were assessed before and after drug switching to sacubitril/valsartan (200 mg/day).

Results: Clinic SBP and DBP significantly decreased after drug switching to sacubitril/valsartan ( P < 0.0001, respectively). Serum creatinine, estimated glomerular filtration rate (eGFR), and urinary protein did not change after switching to sacubitril/valsartan, but serum uric acid significantly decreased (5.70 ± 1.44 to 5.40 ± 1.43 mg/dl, P = 0.0017). The degree of uric acid lowering was greater in patients switching from ARB plus diuretic than in those switching from ARB, but switching to sacubitril/valsartan from ARB only (except losartan) also significantly decreased uric acid levels. In all subjects, the change in serum uric acid after drug switching to sacubitril/valsartan was closely correlated with the change in eGFR ( r = -0.5264, P < 0.0001).

Conclusion: Our findings indicate that switching from ARB to sacubitril/valsartan reduces serum uric acid levels in hypertensive patients and suggest that this uric acid-lowering effect may be associated with an increase in eGFR.

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高血压患者服用沙库比妥/缬沙坦降低血清尿酸的效果：通过转换血管紧张素 II 受体阻滞剂进行评估。

目的：由于高尿酸血症是心血管疾病和慢性肾脏疾病的危险因素，因此在对高血压患者进行药物治疗时有必要关注尿酸水平的变化趋势。本研究探讨了将血管紧张素 II 受体阻滞剂（ARB）换成沙库比特利/缬沙坦对接受治疗的高血压患者血清尿酸水平的影响，并进一步研究了影响尿酸水平的相关因素：方法：在75名至少使用一种降压药（包括ARB）治疗的高血压患者中，评估他们在改用沙库比特利/缬沙坦（200毫克/天）前后的临床血压和生化指标：结果：改用沙库比特利/缬沙坦后，临床SBP和DBP明显下降（P分别<0.0001）。改用沙库比特利/缬沙坦后，血清肌酐、估计肾小球滤过率（eGFR）和尿蛋白没有变化，但血清尿酸明显下降（5.70 ± 1.44 至 5.40 ± 1.43 mg/dl，P = 0.0017）。从ARB加利尿剂改用萨库比特利/缬沙坦的患者尿酸降低程度高于从ARB改用萨库比特利/缬沙坦的患者，但从仅使用ARB（洛沙坦除外）改用萨库比特利/缬沙坦也能显著降低尿酸水平。在所有受试者中，改用沙库比特利/缬沙坦后血清尿酸的变化与 eGFR 的变化密切相关（r = -0.5264，P < 0.0001）：我们的研究结果表明，从 ARB 改用沙库比特利/缬沙坦可降低高血压患者的血清尿酸水平，并表明这种降尿酸效果可能与 eGFR 的增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Blood Pressure Monitoring 医学-外周血管病

CiteScore

2.00

自引率

7.70%

发文量

110

审稿时长

>12 weeks

期刊介绍： Blood Pressure Monitoring is devoted to original research in blood pressure measurement and blood pressure variability. It includes device technology, analytical methodology of blood pressure over time and its variability, clinical trials - including, but not limited to, pharmacology - involving blood pressure monitoring, blood pressure reactivity, patient evaluation, and outcomes and effectiveness research. This innovative journal contains papers dealing with all aspects of manual, automated, and ambulatory monitoring. Basic and clinical science papers are considered although the emphasis is on clinical medicine. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.