Department of Internal Medicine, Kansai Medical University Kori Hospital, Neyagawa, Osaka, Japan.
Department of Nephrology and Hypertension, Dokkyo Medical University, Mibu, Tochigi, Japan.
J Clin Hypertens (Greenwich). 2023 Mar;25(3):304-308. doi: 10.1111/jch.14635. Epub 2023 Feb 1.
This study assessed the efficacy and safety of sacubitril/valsartan in 23 hemodialysis patients with hypertension (mean age 70 years; male 69.6%) after switching from azilsartan, an angiotensin receptor blocker. Both at baseline and 3 months after the start of sacubitril/valsartan treatment, home blood pressure (BP), BP values during hemodialysis, and N-terminal pro-brain natriuretic peptide (NT-proBNP) level were measured. The mean dosage of azilsartan was 30 ± 10 mg/day at baseline and that of sacubitril/valsartan after 3 months of treatment was 204 ± 64 mg/day. After 3 months, significant reductions in mean morning home BP (155 ± 17/80 ± 12 to 147 ± 16/76 ± 11 mmHg), mean nighttime home systolic BP (153 ± 19 to 144 ± 16 mmHg), and median (IQRs) NT-proBNP level [8124 (2620-13 394) to 6271 (1570-9591) pg/mL] were observed (all P < .05), whereas BP values during hemodialysis did not change significantly. In hemodialysis patients, except for hypotension, sacubitril/valsartan was generally well tolerated, effectively controlled out-of-office BP, and improved NT-proBNP.
这项研究评估了在 23 名接受阿齐沙坦（一种血管紧张素受体阻断剂）治疗的高血压血液透析患者（平均年龄 70 岁；男性 69.6%）转为使用沙库巴曲缬沙坦后的疗效和安全性。在开始使用沙库巴曲缬沙坦治疗前和治疗 3 个月时，均测量了家庭血压（BP）、血液透析期间的 BP 值和 N 末端脑利钠肽前体（NT-proBNP）水平。基线时阿齐沙坦的平均剂量为 30±10mg/天，治疗 3 个月后沙库巴曲缬沙坦的剂量为 204±64mg/天。治疗 3 个月后，平均晨家庭 BP（155±17/80±12 至 147±16/76±11mmHg）、平均夜间家庭收缩压（153±19 至 144±16mmHg）和中位数（IQR）NT-proBNP 水平[8124（2620-13394）至 6271（1570-9591）pg/mL]显著降低（均 P<.05），而血液透析期间的 BP 值没有显著变化。在血液透析患者中，除低血压外，沙库巴曲缬沙坦总体耐受良好，能有效控制诊室外 BP，并改善 NT-proBNP。
