Role of Neprilysin Inhibitor Combinations in Hypertension
Role of Neprilysin Inhibitor Combinations in Hypertension
From the available evidence, LCZ696 have shown impressive reduction in systolic and diastolic BP; however, the long-term antihypertensive efficacy of LCZ696 has not been fully evaluated. Also the effect of LCZ696 on cardiovascular outcomes in patients with hypertension is unknown. In the PARADIGM trial, LCZ696 showed a striking reduction in cardiovascular mortality and morbidity in patients with HFrEF. However, it is to be seen whether LCZ696 confers similar long-term prognostic benefits in patients with hypertension. Further studies need to be conducted to elucidate the role of LCZ696 in patients with (i) diabetes, (ii) chronic kidney disease, (iii) elderly, (iv) resistant hypertension. Since blacks were underrepresented in the two published hypertension trials, future trials should include adequate black population. Most importantly, studies needs to be conducted comparing antihypertensive efficacy and outcome of LCZ696 with other drug classes such as calcium-channel blockers and diuretics.
Conclusions
From the available evidence, LCZ696 have shown impressive reduction in systolic and diastolic BP; however, the long-term antihypertensive efficacy of LCZ696 has not been fully evaluated. Also the effect of LCZ696 on cardiovascular outcomes in patients with hypertension is unknown. In the PARADIGM trial, LCZ696 showed a striking reduction in cardiovascular mortality and morbidity in patients with HFrEF. However, it is to be seen whether LCZ696 confers similar long-term prognostic benefits in patients with hypertension. Further studies need to be conducted to elucidate the role of LCZ696 in patients with (i) diabetes, (ii) chronic kidney disease, (iii) elderly, (iv) resistant hypertension. Since blacks were underrepresented in the two published hypertension trials, future trials should include adequate black population. Most importantly, studies needs to be conducted comparing antihypertensive efficacy and outcome of LCZ696 with other drug classes such as calcium-channel blockers and diuretics.