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The treatment of resistant hypertension is challenging LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor, concomitantly inhibits neprilysin and blocks angiotensin type 1 receptor. Previous trials indicated that the dual actions of LCZ696 lead to further lowering of blood pressure (BP), compared with the angiotensin-receptor blocker. We therefore conducted a meta-analysis to evaluate the efficacy and safety of therapy with LCZ696 and ngiotensin-receptor blocker in patients with hypertension on major cardiovascular outcomes.RCTs were obtained from searches of PubMed, EmBase, and the Cochrane Library electronic databases until Feb. 2016. The effects of LCZ696 on systolic BP, diastolic BP and 24-h ambulatory BP or adverse events in patients were included for analysis. The quality assessment, sensitivity analyses, subgroup analyses, and publication biases were also conducted.Five Randomized controlled trials (RCTs) included with 1927 patients were eligible. Relative to the ngiotensin-receptor blocker, LCZ696 treatment in patients decreased systolic BP (−2.70 mmHg, −4.61 to −0.80, p < 0.001), diastolic BP (2.97 mmHg, 95% CI −4.88 to −1.07, p < 0.001), 24-h ambulatory diastolic BP (−2.17 mmHg, 95% CI −3.28 to −1.06; p < 0.001), 24-h ambulatory systolic (BP −2.04 mmHg, −2.61 to −0.73, p < 0.001). No cases of angio-oedema were reported, only three serious adverse events occurred, of which none was judged to be related to the study drug, and no patients died. The LCZ696-based regimen was generally well-tolerated and could present a treatment option for hypertension inpatients especially in effective BP reduction.Compared with ARB, LCZ696 has proved to be a potent, effective antihypertensive agent, complementary and fully additive reduction of blood pressure. LCZ696 was shown to be safe and well tolerated.