Influence of Aging on Outcomes of Sacubitril/ Valsartan in Hypertensive Patients with Heart Failure: A Multicenter Retrospective Study

Background: The aim of this study was to investigate the influence of aging on the effec- tiveness and tolerance of sacubitril/valsartan (sac/val) among hypertensive patients complicated with heart failure in a real -world setting. Methods: This multicenter, retrospective study included patients (>= 18 years old) admit- ted with a diagnosis of hypertension and heart failure, starting sac/val therapy between January 2020 and December 2021 from 3 medical centers. Patients were grouped by the cutoff age of 65 years. Outcomes were collected 31-365 days after the initiation of sac/ val and were compared in a matched cohort after 1 : 1 propensity score matching (PSM). Results: A total of 794 patients were finally analyzed. Blood pressure and cardiac func- tions improved significantly compared with values at baseline. There were 269 patients in each cohort (<65 years and >= 65 years) after PSM. After PSM, the incidence of hyperuri- cemia and hypotension in the elderly patients (>= 65 years) was significantly higher than in those <65 years of age. Kaplan-Meier estimate suggested that the cumulative incidence of new or recurrent cardiovascular events increased significantly at the age of >= 65 years after the point of 3 months (log -rank P = .00087). Conclusion: Sac/val benefited patients in both cohorts by improving blood pressure and cardiac function. Elderly patients (>= 65 years) were susceptible to hypotension, low dia- stolic blood pressure, hyperuricemia, and underwent cardiac -related readmissions more frequently.