Effect of sacubitril/valsartan on serum uric acid and blood pressure in patients with hypertension and asymptomatic hyperuricemia: A randomized clinical trial.
Meng-Bo Wu, Jiao Yang, Cong-Cong Ding et al.
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In 30 seconds
This single-centre, prospective, open-label randomised trial compared sacubitril/valsartan with valsartan in adults with mild-to-moderate primary hypertension and asymptomatic hyperuricemia. Participants received one of the two drugs, with stepwise amlodipine add-on for blood pressure control, and were followed for 12 weeks. In the adjusted intention-to-treat analysis, sacubitril/valsartan was associated with a greater reduction in serum uric acid at week 12 than valsartan (β = 30.13 μmol/L; 95% CI, 4.33-55.92; P = 0.022). Blood pressure control was comparable between groups.
Key findings
- At week 12, sacubitril/valsartan was associated with a greater serum uric acid reduction than valsartan (β = 30.13 μmol/L; 95% CI, 4.33-55.92; P = 0.022).
- Blood pressure control at week 12 was comparable between treatment groups.
- Amlodipine escalation to 10 mg was more frequent with valsartan than sacubitril/valsartan: 17/75 [22.67%] vs. 4/75 [5.33%]; P = 0.008.
Why it matters
Hypertension and asymptomatic hyperuricemia often coexist, and this trial suggests that antihypertensive choice may influence serum uric acid while maintaining similar blood pressure control. The result adds comparative evidence about the urate profile of sacubitril/valsartan in this population, but does not establish whether the observed biochemical difference changes renal or cardiovascular outcomes.
What to keep in mind
The trial was single-centre, open-label, and followed participants for only 12 weeks; it assessed serum uric acid rather than clinical renal or cardiovascular outcomes.