HIỆU QUẢ HẠ HUYẾT ÁP CỦA SACUBITRIL/VALSARTAN Ở BỆNH NHÂN LỌC MÁU NGOÀI THẬN CÓ TĂNG HUYẾT ÁP: KẾT QUẢ TỪ NGHIÊN CỨU PHÂN TÍCH GỘP

Abstract

Objective: The aim of this study is to evaluate the blood pressure-lowering efficacy of sacubitril/valsartan (S/V) in end-stage kidney disease patients with hypertension undergoing dialysis. Methods: The PubMed/MEDLINE database and reference lists of included articles were searched to identify relevant studies. The outcomes of interest were the change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) after S/V treatment compared to baseline. A random-effects meta-analysis was conducted. Results: Seven observational studies comprising 447 patients with a mean/median age ranging from 45.8 to 70 were included in the meta-analysis. All studies were conducted in Asian patients. The male proportion ranged from 59.6% to 83.3%, and the median dialysis vintage ranged from 16 to 93.6 months. S/V dosages varied primarily from 100 to 200 mg/day, and the median follow-up duration ranged from 3 to 11.6 months. The meta-analysis revealed a significant reduction in both SBP (mean reduction of 10.17 mmHg; 95% CI: 5.61 – 14.74) and DBP (mean reduction of 4.38 mmHg; 95% CI: 1.76 – 6.99) with S/V treatment. Conclusions: A meta-analysis of seven studies indicates that sacubitril/valsartan therapy significantly lowers both SBP and DBP in end-stage kidney disease patients with hypertension undergoing hemodialysis. Sacubitril/valsartan may be considered in the management of hypertension in this population, especially in cases of refractory hypertension.