There are approximately 245 million adults with hypertension in China. According to the most recent China Hypertension Survey conducted by the National Center for Cardiovascular Disease from October 2012 to December 2015¹, hypertension awareness, treatment and control rates were 51.6%, 45.8% and 15.3%, respectively. Because of low awareness, at their initial contact with a doctor, many Chinese hypertensive patients often already show serious target organ damage or even overt cardiovascular disease, such as left ventricular hypertrophy (LVH), renal dysfunction and so on. That explains why many Chinese hypertensive patients are at high cardiovascular risk. Given the increasing longevity and prevalence of hypertension in China, there is a huge challenge in the management of hypertension in this populous country.

Nonetheless, the treatment of hypertension has been progressively evolving, with a focus on target organ protection, through the use of newer antihypertensive medications. Indeed, several classes of new antihypertensive drugs are currently in various phases of development. An angiotensin receptor-neprilysin inhibitor (ARNI) has been recently approved for the treatment of hypertension in some countries and will probably soon be approved in China. ARNI is a dual inhibitor that acts on the renin-angiotensin (RAAS) and natriuretic peptide systems. 14 clinical trials have consistently demonstrated that ARNI has significant treatment benefits on clinic and ambulatory systolic and diastolic blood pressure and pulse pressure, and central hemodynamics.

ARNI has been widely used in the treatment of heart failure in China since its approval in 2017. ARNI can reverse cardiac remodeling, including left ventricular hypertrophy. Hypertension is the most powerful risk for these functional and structural cardiac lesions. The use of ARNI in the treatment of hypertension will probably further improve cardiovascular protection and prevention in hypertensive patients.

1. Wang Z, et al. Circulation. 2018; 137(22): 2344-2356

Clinical Topics: Cardiovascular Care Team, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Lipid Metabolism, Novel Agents, Acute Heart Failure, Heart Failure and Cardiac Biomarkers, Hypertension

Keywords: ACC International, Antihypertensive Agents, Blood Pressure, Cardiovascular Diseases, Renin, Neprilysin, Hypertrophy, Left Ventricular, Angiotensins, Receptors, Angiotensin, Ventricular Remodeling, Renin-Angiotensin System, China, Hypertension, Heart Failure, Natriuretic Peptides, Natriuretic Peptides, Medicine, Kidney Diseases

< Back to Listings