Effects of Sacubitril/Valsartan Compared With ARBs or CCBs

A meta-analysis of 15 randomized controlled trials involving 4,824 patients with high blood pressure found that sacubitril/valsartan significantly improved multiple ambulatory blood pressure measures compared with angiotensin receptor blockers (ARBs) or calcium channel blockers (CCBs), with a favorable safety profile. Compared with ARBs or CCBs, sacubitril/valsartan reduced 24-hour systolic and diastolic blood pressure variability, as well as 24-hour, daytime, and nighttime ambulatory blood pressure, while also increasing the proportion of patients with a normal “dipper” blood pressure pattern and improving blood pressure control rates. Both 200 mg/day and 400 mg/day doses showed superior antihypertensive efficacy. In terms of safety, adverse events were similar to those with CCBs; compared with ARBs, sacubitril/valsartan 200 mg/day was associated with fewer serious adverse events and a lower overall rate of liver function abnormalities. The meta-analysis included randomized controlled trials identified through June 2025, and sensitivity analyses supported the robustness of the findings. These results suggest that sacubitril/valsartan may provide effective 24-hour blood pressure control and favorable tolerability in patients with high blood pressure. Source: https://journals.lww.com/cardiovascularpharm