Efficacy and Safety Comparative of Sacubitril/Valsartan vs. Olmesartan in the Treatment of hypertension: A Meta-analysis of RCTs

Am J Hypertens. 2023 Nov 15;36(12):643-650. doi: 10.1093/ajh/hpad075.

Abstract

Background: Sacubitril/valsartan (LCZ696) is a widely used drug for hypertension in Asia, popular for its efficacy and safety. However, there has been no comprehensive literature review comparing it with olmesartan. This meta-analysis compared the antihypertensive and adverse effects of sacubitril/valsartan and olmesartan.

Methods: We conducted a comprehensive search of Pubmed, Web of Science, Embase, Cochrane Library, and ClinicalTrials.gov databases to identify eligible randomized controlled trials (RCTs). The data were then analyzed and processed using Revman 5.4 and Stata SE14 software.

Results: Six RCTs with 4,127 patients were identified, showing that LCZ696 had better blood pressure control than olmesartan; mean sitting systolic and diastolic blood pressure, sitting pulse pressure, 24-hour ambulatory systolic blood pressure, and 24-hour ambulatory diastolic blood pressure were significantly decreased with LCZ696 compared with olmesartan. No significant difference between LCZ696 and olmesartan was observed in the occurrence of the majority of adverse events, with a decreased probability of headache in patients with sacubitril/valsartan compared with olmesartan. The subgroup analysis showed treatment with 400 mg/d LCZ696 was better than olmesartan in reducing serious adverse events.

Conclusions: Sacubitril/valsartan was better than olmesartan in controlling blood pressure in patients with hypertension, with relatively higher safety.

Keywords: blood pressure; hypertension; meta-analysis; olmesartan; sacubitril/valsartan.

Publication types

  • Meta-Analysis

MeSH terms

  • Aminobutyrates / adverse effects
  • Angiotensin Receptor Antagonists / adverse effects
  • Antihypertensive Agents* / adverse effects
  • Biphenyl Compounds / adverse effects
  • Blood Pressure
  • Drug Combinations
  • Humans
  • Hypertension* / chemically induced
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Imidazoles*
  • Tetrazoles / adverse effects
  • Valsartan / adverse effects

Substances

  • sacubitril and valsartan sodium hydrate drug combination
  • olmesartan
  • Antihypertensive Agents
  • sacubitril
  • Valsartan
  • Tetrazoles
  • Aminobutyrates
  • Biphenyl Compounds
  • Drug Combinations
  • Angiotensin Receptor Antagonists
  • Imidazoles