Analysis of Sacubitril/Valsartan Prescribing Trends in Hypertensive Patients in Japan
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By
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Aya F. Ozaki
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Hisanaga Nomura
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Tomohiro Terada
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Eri T. Kato
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Ali A. Naqvi
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Julie T. Nguyen
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Yuki Kunitsu
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July 17, 2026
Clinical Scorecard: Analysis of Sacubitril/Valsartan Prescribing Trends in Hypertensive Patients in Japan
At a Glance
| Category | Detail |
|---|
| Condition | Hypertension |
| Key Mechanisms | Sacubitril/valsartan (S/V) provides antihypertensive effects and is used in combination with other antihypertensive agents. |
| Target Population | Adults with hypertension in Japan, excluding those with heart failure. |
| Care Setting | Real-world clinical practice using a nationwide electronic health record database. |
Key Highlights
- 63.6% of patients received S/V with a calcium channel blocker (CCB).
- 22.5% of patients received S/V as monotherapy.
- 11.8% were treated with S/V plus a CCB and thiazide in triple therapy.
- S/V discontinuation rate was 11.8% by day 90.
- Approximately half of patients on triple therapy discontinued the thiazide diuretic within 30 days.
Guideline-Based Recommendations
Diagnosis
- Hypertension diagnosed using ICD-10 codes I10–I15.
Management
- S/V is not recommended as a first-line agent but can be used in combination with other antihypertensive medications.
Monitoring & Follow-up
- Monitor for discontinuation rates and potential side effects, especially in patients on triple therapy.
Risks
- Increased risk of side effects when combining S/V with thiazide diuretics.
Patient & Prescribing Data
9,486 adults with hypertension, median age 79 years.
Majority transitioned from RAAS inhibitors plus CCB to S/V plus CCB.
Clinical Best Practices
- Consider patient history and current antihypertensive therapy before initiating S/V.
- Evaluate the need for combination therapy and monitor for discontinuation of thiazide diuretics.
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