Comparison of sacubitril/valsartan with olmesartan for hypertension: A meta-analysis of randomized controlled trials

Abstract

Introduction: The efficacy of sacubitril/valsartan versus olmesartan remains controversial for the control of hypertension. We conduct a systematic review and meta-analysis to explore the influence of sacubitril/valsartan versus olmesartan on the control of hypertension. Methods: We have searched PubMed, Embase, Web of science, EBSCO, and Cochrane library databases through July 2023 for randomized controlled trials assessing the effect of sacubitril/valsartan versus olmesartan on the control of hypertension. This meta-analysis is performed using the random-effect model or fixed-effect model based on the heterogeneity. Results: Seven randomized controlled trials and 3677 patients were included in the meta-analysis. Overall, compared with olmesartan treatment for hypertension, sacubitril/valsartan treatment was associated with substantially decreased systolic blood pressure (mean difference [MD] = −4.58; 95% confidence interval [CI] = −7.90 to −1.25; P = .007), diastolic blood pressure (MD = −1.70; 95% CI = −3.24 to −0.17; P = .03), and pulse pressure (MD = −2.31; 95% CI = −4.41 to −0.21; P = .03), as well as improved systolic blood pressure control (odds ratio [OR] = 1.65; 95% CI = 1.15 to 2.38; P = .006), but had no influence on diastolic blood pressure control (OR = 1.33; 95% CI = 0.93 to 1.88; P = .11) or adverse events (OR = 1.06; 95% CI = 0.90 to 1.24; P = .51). Conclusions: Sacubitril/valsartan is better than olmesartan for the reduction of blood pressure for patients with hypertension.