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Advances in health and medicine.
Marjorie Bekaert Thomas
Advances in health and medicine.
Cardiovascular Health Channel
Reported March 17, 2010

Dual Action Drug Fights High Blood Pressure, Heart Disease

(Ivanhoe Newswire) -- A new dual-action drug, called LCZ696, is well tolerated and provides significantly greater reductions in blood pressure than the established angiotensin receptor blocker (ARB) valsartan. LCZ696 might be superior to standard ARBs and could be a promising treatment for hypertension and heart disease.

The single-molecule LCZ696 is an angiotensin-II-receptor and neprilysin inhibitor (ARNI) that works in two ways. Like ARBs, it blocks the action of angiotensin II, a hormone that causes arteries to constrict, and therefore should allow blood to flow more easily. It also neutralizes a substance called neprilysin, which results in the blood vessels relaxing and widening, thereby lowering blood pressure. Because the drug blocks both angiotensin II and neprilysin, it has the potential to offer superior benefits for the treatment of hypertension and heart failure.

Luis Ruilope from Hospital 12 de Octubre, Madrid, Spain, and colleagues examined whether the dual action of LCZ696 leads to further lowering of blood pressure compared with the ARB valsartan.

A total of 1,328 patients with mild-to-moderate hypertension were recruited from 18 countries and randomly assigned to eight-week treatment in one of eight groups: 100 mg LCZ696, 200 mg LCZ696, 400 mg LCZ696, 80 mg valsartan, 160 mg valsartan, 320 mg valsartan, 200 mg AHU377, or placebo.

Overall, patients treated with LCZ696 had significant reductions in blood pressure compared with valsartan. LCZ696 treatment was safe and generally well tolerated at all doses. Side effects were infrequent, mild, and similar among the eight treatment groups—the most common being headaches which occurred most frequently in the placebo group. No cases of angio-edema (swelling) were reported.

In an accompanying comment, Bernard Waeber and Francois Feihl from the Université de Lausanne in Switzerland were quoted as saying that there is great potential for this dual-acting drug, because most people with high blood pressure currently need to take more than one antihypertensive drug to target different mechanisms that affect the cardiovascular system, and thereby manage blood pressure effectively.

They concluded, "To date, clinical experience with LCZ696 was limited. We now have sufficient encouraging data to justify the carrying out of large clinical trials in various clinical conditions, notably hypertension, diabetes, and heart or renal failure."

SOURCE: The Lancet, Online, March 16, 2010

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