Neprilysin is an endopeptidase that breaks down vasoactive peptides (BNP, bradykinin, and adrenomedullin) its inhibition may therefore reduce remodeling, vasoconstriction, and renal sodium retention and improve outcomes in HFrEF. While beta blockers and aldosterone antagonists have further improved survival, mortality remains high. It is also associated with a reduction in all-cause mortality.ĪCE inhibitor therapy reduces mortality in patients with HFrEF and has been the standard of care in this disease since the 1990s following publications of trials like CONSENSUS (1987) and SOLVD (1991), though ARBs may be substituted if ACE inhibitors are poorly tolerated. Among patients with HFrEF, does treatment with an angiotensin receptor-neprilysin inhibitor reduce CV mortality or HF hospitalizations when compared to ACE inhibitor therapy?Īmong patients with HFrEF, treatment with an angiotensin receptor-neprilysin inhibitor reduces CV mortality or HF hospitalizations when compared to enalapril.
