Blood Pressure Management with Sacubitril/Valsartan

Guideline Recommendations

• The European Society of Cardiology notes that sacubitril/valsartan awaits supportive evidence from cardiovascular outcomes trials prior to guideline endorsement for routine use in hypertension 1
• The European Society of Cardiology guidelines note sacubitril/valsartan causes more symptomatic hypotension than valsartan, requiring careful blood pressure monitoring 3

Safety and Usage

• The drug is FDA-approved for heart failure with reduced ejection fraction, not specifically for hypertension treatment, and should not be combined with ACE inhibitors or direct renin inhibitors due to increased risk of adverse events 2
• Dose adjustment is required in patients with creatinine clearance <30 mL/min or moderate hepatic impairment, with a starting dose of 24/26 mg twice daily 3