What they do

ARNI is a new drug class and therefore new to heart failure treatment. After ingestion, the medication induces two main effects. The first effect is similar to the effect ACEs and ARBs have (see above). The other effect strengthens a hormonal system regulated by the heart muscle itself, which releases BNP. BNP or Brain Natriuretic Peptide has multiple effects such as vasodilatation of blood vessels, natriuresis, which means increased salt elimination by the kidney as well as an increased diuresis. ARNIs are an option for those patients who continue having symptoms despite otherwise optimal treatment.

What are the expected benefits?

One large study showed that ARNIs reduced heart failure-related hospitalisations and prolonged life.

Side effects

Side effects include low blood pressure, dizziness, and worsening kidney function. Therefore, as with ACE inhibitors and ARBs, regular monitoring is needed. Patients taking an ARNI must not take an ACE inhibitor or an ARB at the same time.

Also known as:

Sacubitril Valsartan (Entresto®)

Return to Heart failure medicines