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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
The achievement rate for a target blood pressure (BP) of less than 130/80 mmHg is less than 30% in Japanese patients, with no improvements over the past decade. Although angiotensin II receptor blockers and calcium channel blockers (CCBs) are widely used, thiazide diuretics, which are highly recommended by the JSH guidelines, are used by less than 10% of patients. We previously demonstrated the superiority of switching to sacubitril-valsartan over thiazide add-on treatment in BP reduction and favorable changes in estimated glomerular filtration rate (eGFR), uric acid, and glycated hemoglobin A1c levels, with better treatment tolerability. This study aimed to evaluate the differences in long-term efficacy and safety between switching to sacubitril-valsartan and thiazide add-on treatment in Japanese patients with poorly controlled BP.
Patients with showed ≥130/80 mmHg or home BP ≥125/75 mmHg despite treatment with a combination of renin-angiotensin system (RAS) inhibitors and CCBs were included. Patients who added thiazide diuretics (TZD group, n=301) were compared with those who switched from RAS inhibitors to sacubitril-valsartan (SacVal group, n=429). The rate of discontinuation due to adverse effects was analyzed using the Cox proportional hazards model. Among the 548 patients who continued treatment for 24 months, 309 patients (177 in the SacVal group and 132 in the TZD group) with complete data were analyzed using a propensity score method with inverse probability weighting (PS-IPW).
The baseline characteristics of included 730 patients were as follows (TZD group/SacVal group); female: 36%/34%, type2 diabetes 44%/46%, age: 67.3±13.4/72.5±26.6 (p<0.001), chronic heart failure: 11%/19% (p=0.002), systolic BP (mmHg): 150.3±15.1/144.4±16.8 (p<0.001), BMI: 26.1±5.0/25.4±4.3 (p=0.03), eGFR (ml/min/1.73m2): 61.1±21.2/54.9±21.3 (p<0.001), respectively.
Treatment discontinuation due to adverse effects was significantly less frequent in 33 cases (8%) in the SacVal group than in 54 cases (18%) in the TZD group, with a hazard ratio of 0.40 [95% CI, 0.26, 0.61, p<0.001].
In the PS-IPW model, the achievement rate for office BP of less than 130/80 mmHg after 24 months of treatment was significantly higher in the SacVal group than in the TZD group (37% vs. 23%, p<0.01). Systolic BP (mmHg) and uric acid level (mg/dl) were significantly lower in SacVal group than TZD group (132.6±13.5 vs 136.0±13.2, p=0.03, and 5.5±1.2 vs 6.1±1.1, p<0.001, respectively). Further, eGFR slope (ml/min/1.73m2/year) over 24 months was significantly smaller in the SacVal group than the TZD group (-1.8±5.4 vs -3.2±5.1, p=0.03).
Compared to thiazide add-on treatment, switching to sacubitril-valsartan resulted in a superior reduction in BP and favorable changes in uric acid and kidney function, with better treatment adherence in long-term treatment.
