Publication: Angiotensin receptor neprilysin inhibitor as a novel antihypertensive drug: Evidence from Asia and around the globe
1
Issued Date
2021-03-01
Resource Type
ISSN
17517176
15246175
15246175
Other identifier(s)
2-s2.0-85097424703
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Clinical Hypertension. Vol.23, No.3 (2021), 556-567
Suggested Citation
Donna S.H. Lin, Tzung Dau Wang, Peera Buranakitjaroen, Chen Huan Chen, Hao Min Cheng, Yook Chin Chia, Apichard Sukonthasarn, Jam Chin Tay, Boon Wee Teo, Yuda Turana, Ji Guang Wang, Kazuomi Kario Angiotensin receptor neprilysin inhibitor as a novel antihypertensive drug: Evidence from Asia and around the globe. Journal of Clinical Hypertension. Vol.23, No.3 (2021), 556-567. doi:10.1111/jch.14120 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/78423
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Title
Angiotensin receptor neprilysin inhibitor as a novel antihypertensive drug: Evidence from Asia and around the globe
Other Contributor(s)
Siriraj Hospital
Sunway University
Jichi Medical University
Shanghai Jiao Tong University School of Medicine
National Taiwan University Hospital
National Yang-Ming University Taiwan
Universitas Katolik Indonesia Atma Jaya
Department of Medicine
Universiti Malaya
Veterans General Hospital-Taipei
Tan Tock Seng Hospital
Chiang Mai University
Sunway University
Jichi Medical University
Shanghai Jiao Tong University School of Medicine
National Taiwan University Hospital
National Yang-Ming University Taiwan
Universitas Katolik Indonesia Atma Jaya
Department of Medicine
Universiti Malaya
Veterans General Hospital-Taipei
Tan Tock Seng Hospital
Chiang Mai University
Abstract
Hypertension is a worldwide epidemic that continues to grow, with a subset of patients responding poorly to current treatment available. This is especially relevant in Asia, which constitutes 61% of the global population. Hypertension in Asia is a unique entity that is often salt-sensitive, nocturnal, and systolic predominant. Sacubitril/valsartan is a first-in-class angiotensin receptor neprilysin inhibitor that was first used in heart failure with reduced ejection fraction. Sacubitril inhibits neprilysin, a metallopeptidase that degrades natriuretic peptides (NPs). NPs exert sympatholytic, diuretic, natriuretic, vasodilatory, and insulin-sensitizing effects mostly via cyclic guanosine monophosphate (cGMP)-mediated pathways. As an antihypertensive agent, sacubitril/valsartan has outperformed angiotensin II receptor type 1 blockers (ARBs), with additional reductions of office systolic blood pressures ranging between 5 and 7 mmHg, in multiple studies in Asia and around the globe. The drug was well tolerated even in the elderly or those with chronic kidney disease. Its mechanisms of actions are particularly attractive for treatment of hypertension in Asia. Sacubitril/valsartan offers a novel, dual class, single-molecule property that may be considered as first-line antihypertensive therapy. Further investigations are needed to validate its safety for long-term use and to explore other potentials such as in the management of insulin resistance and obesity, which often coexist with hypertension in Asia.