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<p>Hyperuricaemia is a known cardiovascular risk factor. Several angiotensin receptor blockers, such as losartan, can decrease serum uric acid level, but the effect on serum uric acid of angiotensin receptor neprilysin inhibitor remains unclear. This analysis aimed to investigate the effects of Sacubitril/Allisartan on serum uric acid level in Chinese patients with both hypertension and hyperuricaemia. We performed post-hoc analysis of data from a randomized controlled trial that compared the blood pressure-lowering effect at 12 weeks of treatment with Sacubitril/Allisartan (240 or 480 mg/d) and Olmesartan (20 mg/d). Hyperuricaemia was defined as a serum uric acid concentration exceeding the limit (420 μmol/L in male and 360 μmol/L in female) or patients already on antihyperuricemic drugs. The outcome measures included serum uric acid levels at 12, 24 and 52 weeks of treatment. Of the 1197 randomized patients, 401 (33.5%) patients with both hypertension and hyperuricaemia were included in this analysis. Mean serum uric acid levels at baseline were 441.4 ± 60.3 μmol/L, 430.5 ± 67.1 μmol/L, and 449.9 ± 78.6 μmol/L for the Sacubitril/Allisartan 240 mg, Sacubitril/Allisartan 480 mg, and Olmesartan groups, respectively (<i>P</i> = 0.41). Over the 12-week double-blind treatment period, serum uric acid levels decreased significantly from baseline in both Sacubitril/Allisartan groups compared to Olmesartan (−7.7 μmol/L), with a more pronounced reduction in the 240 mg (−37.7 μmol/L) and 480 mg groups (−43.3 μmol/L). Least square mean changes in serum uric acid reductions were greater with Sacubitril/Allisartan versus Olmesartan, with a difference of −30.0 μmol/L (<i>P</i> = 0.01) for Sacubitril/Allisartan 240 mg and −35.6 μmol/L (<i>P</i> = 0.002) for Sacubitril/Allisartan 480 mg. Treatment with Sacubitril/Allisartan decreased serum uric acid levels significantly more than Olmesartan in Chinese patients with both hypertension and hyperuricaemia, demonstrating a unique uricosuric effect of Sacubitril/Allisartan.</p><p></p>

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Effects of Sacubitril/Allisartan versus Olmesartan on serum uric acid in Chinese patients with hypertension and hyperuricaemia

  • 期刊论文

  • 发表日期：

    2026年4月20日

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  • Wei Zhang,
  • Jie Yan,
  • Jin Zhang,
  • Qian Ge,
  • Xiao-Hong Lu,
  • Wen-Jie Xu,
  • Jing-Chao Sun,
  • Sheng-Mei Mu,
  • Yan Chen,
  • Zi-Chen Liu,
  • Qiang Wang,
  • Xiang-Nan Zhou,
  • Yan Li,
  • Ji-Guang Wang

摘要

Hyperuricaemia is a known cardiovascular risk factor. Several angiotensin receptor blockers, such as losartan, can decrease serum uric acid level, but the effect on serum uric acid of angiotensin receptor neprilysin inhibitor remains unclear. This analysis aimed to investigate the effects of Sacubitril/Allisartan on serum uric acid level in Chinese patients with both hypertension and hyperuricaemia. We performed post-hoc analysis of data from a randomized controlled trial that compared the blood pressure-lowering effect at 12 weeks of treatment with Sacubitril/Allisartan (240 or 480 mg/d) and Olmesartan (20 mg/d). Hyperuricaemia was defined as a serum uric acid concentration exceeding the limit (420 μmol/L in male and 360 μmol/L in female) or patients already on antihyperuricemic drugs. The outcome measures included serum uric acid levels at 12, 24 and 52 weeks of treatment. Of the 1197 randomized patients, 401 (33.5%) patients with both hypertension and hyperuricaemia were included in this analysis. Mean serum uric acid levels at baseline were 441.4 ± 60.3 μmol/L, 430.5 ± 67.1 μmol/L, and 449.9 ± 78.6 μmol/L for the Sacubitril/Allisartan 240 mg, Sacubitril/Allisartan 480 mg, and Olmesartan groups, respectively (P = 0.41). Over the 12-week double-blind treatment period, serum uric acid levels decreased significantly from baseline in both Sacubitril/Allisartan groups compared to Olmesartan (−7.7 μmol/L), with a more pronounced reduction in the 240 mg (−37.7 μmol/L) and 480 mg groups (−43.3 μmol/L). Least square mean changes in serum uric acid reductions were greater with Sacubitril/Allisartan versus Olmesartan, with a difference of −30.0 μmol/L (P = 0.01) for Sacubitril/Allisartan 240 mg and −35.6 μmol/L (P = 0.002) for Sacubitril/Allisartan 480 mg. Treatment with Sacubitril/Allisartan decreased serum uric acid levels significantly more than Olmesartan in Chinese patients with both hypertension and hyperuricaemia, demonstrating a unique uricosuric effect of Sacubitril/Allisartan.