Effect of sacubitril/valsartan in treating maintenance hemodialysis patients with refractory hypertension

Objective To observe the efficacy of sacubitril/valsartan in treating maintenance hemodialysis patients with refractory hypertension.

Methods From April 2020 to April 2021, a total of 132 maintenance hemodialysis patients with hypertension who were treated with angiotensin receptor neprilysin inhibitor (ARNI) and angiotensin-receptor blockers (ARB) were selected as research objects. The patients were divided into observation group n=64, oral administration of sacubitril/valsartan, (ARNI) and control group n=68, oral administration of valsartan tablets, (ARB) according to the treatment method. Blood pressure control and blood pressure fluctuation during dialysis were compared between the two groups; common clinical parameters of echocardiography were compared between the two groups.

Results After 3 months of treatment, the systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the two groups were significantly lower than those before treatment, and were significantly lower in the observation group than the control group (P < 0.05). The incidence of symptomatic hypertension (complicating with dizziness, chest tightness or arrhythmia) in the observation group was significantly lower than that in the control group (P < 0.05). After treatment, the left atrial inner diameter, the ratio of early diastolic mitral blood flow velocity to early diastolic mitral annular motion velocity(E/Ea) and pulmonary artery pressure in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, left atrial inner diameter, left ventricular inner diameter, E/Ea, pulmonary artery pressure in the observation group were significantly lower than before treatment, and ejection fraction (EF) was significantly higher than before treatment (P < 0.05).

Conclusion For maintenance hemodialysis patients with hypertension, ARNI (sacubitril/valsartan) treatment can improve the quality of dialysis, effectively reduce the incidence of serious adverse events during dialysis treatment, and improve the cardiac function.