Jadhav Uday M, Ray Saumitra, Unni T Govindan, Sawhney J P S, Mehta Ashwani, Guha Shantanu, Karnik Rajiv D, Desai Bhupen N, Khan Aziz, Patel Keyur, Prajapati Jayesh S, Shah Hitesh J, Reddy Rama Krishna, Kumar Sanjeev, Dutta Soumya Kanti, Chakraborty Saujatya, Ahmed Ashfaque, Prasad Ravi Vishnu, Chaudhary Gaurav, Kumar Amit, Manjappa M, Shetty Sujal, Raja Praveen, Shanmugam Vimalraj Bogana
Cardiology, Cardiac CT and Cardiac MRI Department, MGM New Bombay Hospital, Navi Mumbai, India.
Sri Aurobindo Seva Kendra, AMRI Hospital Dhakuria, Kolkata, India.
Cardiol Ther. 2024 Dec;13(4):663-677. doi: 10.1007/s40119-024-00390-5. Epub 2024 Nov 6.
Hypertension, a key modifiable risk factor for cardiovascular diseases (CVD), significantly contributes to premature death and morbidity worldwide. Despite stabilization in age-adjusted global prevalence, the absolute number of hypertensive individuals doubled from 2000 to 2010, largely due to increases in low- and middle-income countries. In 2021, only 21% of hypertensive individuals globally had effective blood pressure (BP) control. In India, hypertension is the leading risk factor for death and disability, with prevalence rates of 24% in men and 21% in women, as reported by the 2019-2020 National Family Health Survey (NFHS-5). Alarmingly, just 25% of rural and 38% of urban hypertensive Indians are undergoing treatment, with only 10% and 20% achieving BP control, respectively. This highlights the hypertension paradox, where clinical inertia and hesitancy in intensifying BP-lowering therapy persist despite the availability of antihypertensive drugs. This expert opinion paper aims to provide a comprehensive evaluation of sacubitril/valsartan in hypertension management, leveraging insights from its approved use in heart failure and examining its benefits and challenges across diverse hypertensive populations. The formulation of this expert opinion involved employing evidence-based methodologies and utilizing all available data. The document underwent scrutiny by expert cardiologists, whose clinical experiences and examination of the evidence and guidelines informed the formation of the expert opinion. This expert opinion paper provides a thorough and informed evaluation of sacubitril/valsartan, highlighting its potential to address unmet needs in BP control, particularly in challenging cases such as resistant hypertension and chronic kidney disease.
高血压是心血管疾病（CVD）的一个关键可改变风险因素，在全球范围内显著导致过早死亡和发病。尽管年龄调整后的全球患病率趋于稳定，但高血压患者的绝对数量在2000年至2010年间翻了一番，这主要是由于低收入和中等收入国家的增加。2021年，全球仅有21%的高血压患者实现了有效的血压（BP）控制。根据2019 - 2020年全国家庭健康调查（NFHS - 5）报告，在印度，高血压是导致死亡和残疾的主要风险因素，男性患病率为24%，女性为21%。令人担忧的是，印度农村地区仅有25%的高血压患者接受治疗，城市地区为38%，其中分别只有10%和20%的患者血压得到控制。这凸显了高血压悖论，即尽管有抗高血压药物，但在强化降压治疗方面仍存在临床惰性和犹豫。本专家意见文件旨在全面评估沙库巴曲缬沙坦在高血压管理中的应用，借鉴其在心力衰竭获批使用中的见解，并审视其在不同高血压人群中的益处和挑战。本专家意见的制定采用了循证方法并利用了所有可用数据。该文件经过了心脏病专家的审查，他们的临床经验以及对证据和指南的审查为专家意见的形成提供了参考。本专家意见文件对沙库巴曲缬沙坦进行了全面且有依据的评估，强调了其满足血压控制未满足需求的潜力，特别是在难治性高血压和慢性肾病等具有挑战性的病例中。
