What Are the Clinical Implications?
hypertension, cardiovascular disease
EVENTS, HYPERTENSION, CARDIOVASCULAR DISEASE, BLIND

Given the contribution of nighttime BP and an abnormal nocturnal BP dipper pattern to cardiovascular risk, treatment with sacubitril/valsartan impacts multiple mechanisms that could improve cardiovascular outcomes in patients with hypertension.A substantial body of evidence shows that nocturnal hypertension is a significant risk factor for developing cardiovascular disease and the occurrence of cardiovascular disease events.Despite this, management of nocturnal hypertension remains an unmet medical need, because most current antihypertensive medication is given once daily in the morning. Unfortunately, this leaves a therapeutic blind spot in the early morning hours, where drug levels (and BP‐lowering effects) are at their lowest point before morning drug dosing. One approach to overcoming these issues is bedtime dosing of antihypertensive therapy.One of these newer agents is the angiotensin receptor neprilysin inhibitor sacubitril/valsartan, which has recently been approved in Japan to treat hypertension.Therefore, this post hoc analysis of randomized clinical trial data evaluated the antihypertensive effects of sacubitril/valsartan compared with olmesartan on 24‐hour, daytime, and nighttime ambulatory BP in patients with mild‐to‐moderate hypertension and in patient subgroups (phenotypes) based on nocturnal BP dipping status.