Angiotensin receptor-neprilysin inhibitor: “Best choice” for obese hypertension

With the global epidemic of high hypertension and obesity, the number of patients with obese hypertension will continue to soar. However, the pathogenesis of obesity-induced hypertension is not completely clear, and there is a lack of targeted drug in clinical treatment. Angiotensin receptor-neprilysin inhibitor (ARNI) is a new cardiovascular drug that acts on both renin-angiotensin system (RAS) and natriuretic peptide system (NPs). As the first agent of ARNI to be marketed in the world, sacubitril/valsartan has been widely used in patients with heart failure with reduced ejection fraction (HFrEF). With the approval of essential hypertension indications, more and more evidence has shown that sacubitril/valsartan is superior to traditional RAS blockers in blood pressure control. Sacubitril/valsartan also has additional benefits such as improving glucose and lipid metabolism and delaying renal deterioration, which may make sacubitril/valsartan the “best choice” for obese hypertension. Through systematic literature review, we discuss the comprehensive therapeutic effect and possible mechanism of sacubitril/valsartan in the control of obese hypertension and provide more theoretical basis for the treatment of hypertension and its complications.