{"id":"7ab21d723808","type":"article","url":"https://hartvaat.nl/2017/01/01/sacubitril-valsartan-en-natriurese-diurese-en-bloeddruk-bij-zoutgevoelige-hypert/","title":"Sacubitril/valsartan en natriurese, diurese en bloeddruk bij zoutgevoelige hypertensie","title_en":"Effects of Sacubitril/Valsartan (LCZ696) on Natriuresis, Diuresis, Blood Pressures, and NT-proBNP in Salt-Sensitive Hypertension.","category":"hypertensie","category_label":"Hypertensie","professions":["apotheker","cardioloog","internist"],"tags":["answer-hf","bloeddrukbehandeling","sacubitril-valsartan"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.116.08484","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.116.08484","authors":["Tzung-Dau Wang","Ru-San Tan","Hae-Young Lee","Sang-Hyun Ihm","Moo-Yong Rhee","Brian Tomlinson","Parasar Pal","Fan Yang","Elizabeth Hirschhorn","Margaret F Prescott","Markus Hinder","Thomas H Langenickel"],"significance":6,"published":"2017-01-01","source_date":"2017-01-01","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/arni-farmacologie/","https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/"],"congress":"","summary_en":"This mechanistic study of sacubitril-valsartan in salt-sensitive hypertension showed enhanced natriuresis, diuresis, and blood pressure reduction, providing pathophysiological insight into ARNI effects on sodium handling.","created":"2026-07-03T10:26:30Z","updated":"2026-07-03T18:38:29Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de effecten van sacubitril/valsartan op natriurese, diurese, bloeddruk en NT-proBNP bij zoutgevoelige hypertensie. Mechanistisch inzicht in de werking van ARNI bij hypertensie.","abstract_original":"UNLABELLED: Salt-sensitive hypertension (SSH) is characterized by impaired sodium excretion and subnormal vasodilatory response to salt loading. Sacubitril/valsartan (LCZ696) was hypothesized to increase natriuresis and diuresis and result in superior blood pressure control compared with valsartan in Asian patients with SSH. In this randomized, double-blind, crossover study, 72 patients with SSH received sacubitril/valsartan 400 mg and valsartan 320 mg once daily for 4 weeks each. SSH was diagnosed if the mean arterial pressure increased by ≥10% when patients switched from low (50 mmol/d) to high (320 mmol/d) sodium diet. The primary outcome was cumulative 6- and 24-hour sodium excretion after first dose administration. Compared with valsartan, sacubitril/valsartan was associated with a significant increase in natriuresis (adjusted treatment difference: 24.5 mmol/6 hours, 50.3 mmol/24 hours, both P<0.001) and diuresis (adjusted treatment difference: 291.2 mL/6 hours, P<0.001; 356.4 mL/24 hours, P=0.002) on day 1, but not on day 28, and greater reductions in office and ambulatory blood pressure on day 28. Despite morning dosing of both drugs, ambulatory blood pressure reductions were more pronounced at nighttime than at daytime or the 24-hour average. Compared with valsartan, sacubitril/valsartan significantly reduced N-terminal pro B-type natriuretic peptide levels on day 28 (adjusted treatment difference: -20%; P=0.001). Sacubitril/valsartan and valsartan were safe and well tolerated with no significant changes in body weight or serum sodium and potassium levels with either treatments. In conclusion, sacubitril/valsartan compared with valsartan was associated with short-term increases in natriuresis and diuresis, superior office and ambulatory blood pressure control, and significantly reduced N-terminal pro B-type natriuretic peptide levels in Asian patients with SSH. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01681576."}