TY  - JOUR
AU  - ZHANG, Wei
AU  - YAN, Jie
AU  - ZHANG, Jin
AU  - GE, Qian
AU  - LU, Xiao-Hong
AU  - XU, Wen-Jie
AU  - SUN, Jing-Chao
AU  - MU, Sheng-Mei
AU  - CHEN, Yan
AU  - LIU, Zi-Chen
AU  - WANG, Qiang
AU  - ZHOU, Xiang-Nan
AU  - LI, Yan
AU  - WANG, Ji-Guang
PY  - 2026
TI  - Blood pressure lowering efficacy of sacubitril/allisartan versus olmesartan in elderly Chinese hypertensive patients
JO  - Journal of Geriatric Cardiology
SN  - 1671-5411
SP  - 505
EP  - 514
VL  - 23
IS  - 8
AB  - BACKGROUNDSacubitril/Allisartan, a novel angiotensin receptor-neprilysin inhibitor, has demonstrated antihypertensive efficacy in patients with hypertension. Its effects in the elderly patients, who often present with increased arterial stiffness and comorbidities, remain less understood.METHODSWe performed analysis of data from a randomized clinical trial that compared the blood pressure-lowering effect at 12 weeks of treatment with sacubitril/allisartan (240 mg/d or 480 mg/d) and olmesartan (20 mg/d). Eligible patients with mild-to-moderate hypertension and aged 65–75 years were included in the analysis. The primary outcome was change in clinic and 24-hour ambulatory blood pressure from baseline to week 12.RESULTSOf the 1197 randomized patients, 338 elderly patients (41.5%) (mean age: 67.9 ± 2.3 years, 49.9% male) were included in this analysis. Baseline characteristics were comparable among treatment groups. At 12 weeks, least square mean (± standard error) changes from baseline in clinic systolic/diastolic blood pressure in the sacubitril/allisartan (240 mg/d or 480 mg/d) group and the olmesartan (20 mg/d) group were −24.0 ± 1.6/−5.7 ± 0.9 mmHg, −26.2 ± 1.6/−6.5 ± 0.9 mmHg, and −21.5 ± 1.6/−6.3 ± 0.9 mmHg, respectively. Greater reductions were also observed with sacubitril/allisartan (480 mg) compared with olmesartan (20 mg) in 24-hour, daytime and nighttime systolic blood pressure (all P-values < 0.05). The reductions in ambulatory blood pressure were dose-dependent (P = 0.007), and significantly greater with sacubitril/allisartan (480 mg) compared with olmesartan (20 mg) for nighttime blood pressure [−17.5 ± 1.8/−8.1 ± 1.0 mmHg, with a difference of −10.9 mmHg (−16.1 to −5.8, P < 0.0001) for systolic blood pressure and −4.5 mmHg (−7.3 to −1.8, P = 0.002) for diastolic blood pressure].CONCLUSIONSIn elderly patients with hypertension, sacubitril/allisartan provided dose-dependent greater blood pressure reductions compared with olmesartan.
UR  - https://doi.org/10.26599/1671-5411.2026.08.002
DO  - 10.26599/1671-5411.2026.08.002