Sacubitril/Valsartan Shows Promise in Reducing Nocturia in Hypertensive Patients, finds study
Japan: A pilot study published in Translational Andrology and Urology suggests that sacubitril/valsartan, a novel antihypertensive therapy, may help reduce nocturia in patients with hypertension. The findings point to a potential dual benefit of the drug in managing both blood pressure and nighttime urinary symptoms, a combination that could improve patient quality of life.
Nocturia, defined as waking during the night to urinate, is a common yet often overlooked condition. It is associated with sleep disruption, increased risk of falls, and reduced overall well-being, particularly among older adults. The condition has a complex origin, often involving reduced bladder capacity, nocturnal polyuria, and underlying comorbidities such as hypertension. Despite its impact, nocturia remains underdiagnosed and inadequately managed in clinical practice.
To explore new therapeutic options, Takeya Kitta and colleagues from the Department of Urology, Hokkaido Memorial Hospital of Urology in Japan, investigated the effects of sacubitril/valsartan in hypertensive patients experiencing nocturia. This medication, an angiotensin receptor-neprilysin inhibitor, is known for its natriuretic and diuretic properties, which may influence fluid balance and nighttime urine production through neurohormonal pathways.
For this purpose, the researchers conducted a 12-week pilot study involving 18 patients with hypertension and nocturia, with a mean age of 66.7 years. Participants were monitored using voiding diaries to assess nighttime urinary frequency. Additional outcomes included sleep quality, nocturia-related quality of life, and symptom scores related to overactive bladder and lower urinary tract symptoms.
The researchers reported the following findings:
- Nighttime urination episodes decreased significantly, with the average frequency dropping from 3.31 to 2.10 times per night.
- The nocturnal polyuria index showed a significant reduction, indicating decreased nighttime urine production.
- Patients experienced improvements in sleep quality.
- Quality of life related specifically to nocturia improved.
- No significant changes were observed in overall prostate symptom scores.
- General quality of life measures did not show significant improvement.
- Nocturia-related symptoms within the overactive bladder assessment showed noticeable improvement.
- The benefits of sacubitril/valsartan are likely linked to reduced nighttime urine production and better blood pressure control.
The study is among the first to explore the role of this medication in managing nocturia, highlighting a possible link between cardiovascular health and urinary symptoms. The authors suggest that cardiovascular conditions may be an underrecognized contributor to nocturia, emphasizing the need for a broader clinical perspective.
Overall, the findings support a more integrated approach to patient care, encouraging collaboration across specialties such as cardiology and urology. Further large-scale studies are needed to confirm these preliminary results and to better define the role of sacubitril/valsartan in the management of nocturia.
Reference:
Kitta T, Kakizaki H, Kihara H. Sacubitril/valsartan improves nocturia in hypertensive patients: a pilot study. Transl Androl Urol. 2026 Feb 28;15(2):44. doi: 10.21037/tau-2025-aw-843. Epub 2026 Feb 11. PMID: 41809793; PMCID: PMC12968870.
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