*For medical professionals only
This article explains the specific application of sacubitril and valsartan in cardiovascular disease!
Sacubitril-Valsartan is the world’s first angiotensin receptor enkephalinase inhibitor (ARNI) drug with a large number of circulating Evidence from medical evidence has proved that it has definite efficacy and good safety in the treatment of heart failure and hypertension, and it has also become a member of the “new quadruple” of heart failure treatment.
Here is a summary of its use in hypertension and heart failure.
1
The composition and effect of sacubitril and valsartan
2
Mechanisms of essential hypertension and heart failure
Heart failure is currently considered to be a chronic, spontaneously progressive disease, and myocardial remodeling caused by activation of the neuroendocrine system is a key factor in the occurrence and development of heart failure. It can be seen that SNS, RAAS, and NPs are involved in both hypertension and heart failure, and sacubitril-valsartan is involved in a variety of mechanisms, so it can effectively reduce blood pressure and improve myocardial remodeling.
3
Mechanism of action of sacubitril-valsartan
The antihypertensive effect of NPs covers the mechanism of action of five major classes of antihypertensive drugs, including natriuretic diuresis, vasodilation, inhibition of RAAS and SNS activity.
4
Specific application of sacubitril and valsartan in cardiovascular disease
5
Sacubitril-Valsartan and ACEI/ARB application connection
(1) angiotensin-converting enzyme inhibitor (ACEI) and sacubitril-valsartan< /strong>
First of all, the two cannot be used together. If the patient has previously used an ACEI, sacubitril and valsartan sodium must be discontinued for at least 36 hours after cessation of ACEI therapy. If sacubitril-valsartan sodium treatment is stopped, ACEI can only be started 36 hours after the last administration of sacubitril-valsartan sodium.
(2) Angiotensin II Receptor Blocker (ARB)Sacubitril and Valsartan
First of all, the two cannot be used together, except for valsartan. Patients who have used ARBs in the past can be directly switched to sacubitril and valsartan sodium.
References:
[1] Hypertension Branch of China International Exchange Promotion Association for Healthcare, Cardiovascular Branch of Chinese Medical Doctor Association, China Hypertension League. Clinical application of sacubitril and valsartan in hypertensive patients Chinese expert advice [J]. Chinese Journal of Hypertension, 2021, 29(2): 108-114.
[2] General Practitioners Branch of Chinese Medical Doctor Association. Expert consensus on the clinical application of sacubitril and valsartan sodium in primary cardiovascular disease [J]. Chinese General Medicine, 2021, 23(24): 2885-2897.
[3] Heart Failure Group of Cardiovascular Branch of Chinese Medical Association, Heart Failure Professional Committee of Chinese Medical Doctor Association, Editorial Board of Chinese Journal of Cardiovascular Pain. Chinese Heart Failure Diagnosis and Treatment Guidelines 2018 [J]. Chinese Journal of Cardiovascular Diseases, 2018, 46(10): 760-789.
This article was first published: Cardiovascular Channel of the Medical Community
The author of this article: Li Xuesong
Review of this article: Jiehui Zhao
Editor in charge: Yuan Xueqing, Zhang Li
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