Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Background: We investigated the effects of sacubitril/valsartan, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), on 24-hour blood pressure (BP) and safety for 12 weeks in Japanese patients with non-dialysis advanced chronic kidney disease (CKD).
Methods: We conducted a prospective, single-arm exploratory study. Patients with non-dialysis CKD stage G4-5 (estimated glomerular filtration (eGFR) <30 mL/min/1.73 m2) who did not achieve their BP goals with angiotensin receptor blocker (ARB) administration, were enrolled and switched to sacubitril/valsartan. Primary and key secondary endpoints were changes from baseline in the 24-hour systolic BP (SBP) measured via ambulatory BP monitoring (ABPM) over 12 weeks and the safety, especially incidence of serum creatinine (Cr) increase (≥ 30% increase from baseline) and hyperkalemia.
Results: Thirty patients were enrolled, and 29 patients were switched to sacubitril/valsartan. Efficacy analysis was conducted on 26 patients. Baseline mean eGFR and office BP were 21.1 ± 5.0 mL/min/1.73m2 and 149.4 ± 23.7/80.7 ± 11.9 mmHg, respectively. Baseline 24-hour, daytime, and nighttime BP were 139.6 ± 17.7/77.0 ± 7.8 mmHg, 143.5 ± 18.5/79.6 ± 8.7 mmHg, and 131.0 ± 20.4/71.1 ± 8.8 mmHg, respectively. After 12 weeks, changes in 24-hour, daytime, and nighttime SBP from baseline were -7.1 ± 12.4 mmHg (P < 0.01), -7.7 ± 12.9 mmHg (P < 0.01), and -5.8 ± 15.8 mmHg (P = 0.07), respectively. No incidences of potassium values > 6.0 mmol/L or serum Cr ≥ 30% increase from baseline were reported after sacubitril/valsartan initiation.
Conclusions: Switching from ARB to sacubitril/valsartan can safely enhance 24-hour antihypertensive treatment in patients with non-dialysis CKD G4-5 who do not achieve BP goals with ARBs. CLINICAL TRIALS REGISTRATION: Trial Number jRCT1031220149.
Clinical Trials Registration: Trial Number jRCT1031220149.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/ajh/hpaf028 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association between the uric acid to high-density lipoprotein ratio (UHR) and hypertension in US adults: evidence from NHANES 2005-2020.
Acta Cardiol
September 2025
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, P.R. China.
Uric acid to HDL ratio (UHR) is a new measure of inflammation that has been widely used to study cardiovascular disease relationships. The aim of this study was to investigate the relationship between uric acid to HDL ratio and hypertension. We found that UHR was positively associated with hypertension prevalence in a nationally representative sample of U.
View Article and Find Full Text PDFPreoperative Oral Clonidine Enhances Surgical Field Quality During Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis With Trial Sequential Analysis.
Int Forum Allergy Rhinol
September 2025
Department of Otolaryngology-Head and Neck Surgery, Al-Jahra Hospital, Al-Jahra, Kuwait.
Background: Various interventions have been proposed to enhance surgical field quality during endoscopic sinus surgery (ESS). This study evaluates whether preoperative oral clonidine enhances surgical field quality during ESS.
Methods: PubMed, Scopus, Web of Science, Embase, and CENTRAL databases were searched.
The role of renal denervation for the treatment of hypertension in patients with chronic kidney disease: a position paper of the Italian Society of Nephrology.
J Nephrol
September 2025
Nephrology and Dialysis Unit, ASL Nord Ovest Toscana, Livorno, Italy.
Hypertension is a clinical condition associated with an increase in cardiovascular morbidity and mortality. In chronic kidney disease (CKD), hypertension is also a driver of faster disease progression. Correct and appropriate treatment with antihypertensive medication reduces the risk of cardiovascular events and slows kidney disease progression.
View Article and Find Full Text PDFThe Role of Worry and Affectivity on Physiological Responses To an Acute Stressor.
Appl Psychophysiol Biofeedback
September 2025
Florida State University, Tallahassee, USA.
The explanation for how acutely stressful experiences could result in proximal health outcomes has been lacking in occupational health research. Although scholars have argued that individual personality and affect could worsen health behaviors, we believe that these qualities also could intensify the experience of acute stressors, potentially explaining why acutely stress encounters result in poor health outcomes for some people, but not others. Our study examines three individual differences - worry, negative affect, and positive affect - that are relevant to differential stress anticipation, reactivity, and recovery.
View Article and Find Full Text PDFCerebral autoregulation in orthostatic hypotension and falls among older adults: a community-based exploratory study.
Clin Auton Res
September 2025
Faculty of Medicine, Department of Medicine, Ageing and Age-Associated Disorders Research Group, Division of Geriatric Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
Background: Orthostatic hypotension (OH) is prevalent in older adults and is often associated with falls. However, the presence or absence of symptoms in OH may be mediated by cerebral autoregulation, which helps maintain cerebral perfusion during blood pressure fluctuations.
Methods: We recruited 40 older adults (aged ≥ 55 years) from the Malaysian Elders Longitudinal Research (MELoR) cohort.