PS-C22-9: ANGIOTENSIN RECEPTOR-NEPRILYSIN INHIBITOR (ARNI) HAS MORE EFFECTS IN REDUCING ALDOSTERONE CONCENTRATIONS AND CARDIAC HYPERTROPHY IN WELL-CONTROLLED HYPERTENSIVE PATIENTS

In recent years, angiotensin receptor neprilysin inhibitor (ARNI), a new class of drugs, has shown good therapeutic effects on cardiovascular disease (CVD) patients in several clinical studies, reducing the morbidity and mortality of CVD patients. In this study, 301 well-controlled essential hypertensive patients with left ventricular dilatation disorder were enrolled and medicated with ARNI for six months replaced from angiotensin receptor blockers (ARB) from April 2021 till March 2022. There were no significant improvements in indices except blood pressure, aldosterone concentrations, left ventricular mass index (MD -3.15 g/m2, 95% CI -3.38, -2.62) and left atrial volume (MD -6.20 mL, 95% CI -11.11, -0.31). The systolic and diastolic blood pressures were significantly reduced from 120.5 ± 0.91 to 115.8 ± 0.86 (p = 0.002) mmHg and from 72.5 ± 0.57 to 69.9 ± 0.54 mmHg, respectively (means ± SEM). Of interest, plasma aldosterone concentrations were significantly reduced from 11.7 ± 1.15 to 6.54 ± 0.56. without significant change of renin concentrations. The patients with primary aldosteronism have increased risks of cardiovascular complications compared with essential hypertensives. ARNI distinctly improved hypertrophy compared with angiotensin receptor blockers, and such effects might be due to the reduced aldosterone concentrations.