ARNIs — A New Option For Managing Heart Failure
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      / Updated July 13th, 2022

      ARNIs A New Option For Managing Heart Failure

      Medically Reviewed: Dr. Andrea Tufano-Sugarman Written by: Laura Gesualdi-Gilmore
      SurvivorNet
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      What to Know About Angiotensin Receptor-Neptrilysin Inhibitors (ARNIs)

      • ARNIs are a relatively new class of drug that are used to reduce the workload on the heart for patients with heart failure.
      • These drugs have shown to be effective in terms of reducing deaths, hospitalizations, and improving heart function for patients with heart failure.
      • Patients considering ARNIs should be aware of potential side effects, such as fatigue, dizziness, and a drop in blood pressure.
      Heart failure occurs when the heart does not pump blood as well as it should. The condition causes fluid to back up in the body and organs throughout the body. The kidneys, liver, and lungs may be impacted because they are not getting as much blood as they need. There are many medications available to treat the condition, including a relatively new class of drugs called angiotensin receptor-neprilysin inhibitors (ARNIs).

      In addition to lifestyle interventions such as cutting out alcohol and adopting a regular workout routine patients may be prescribed a number of medications to get the condition under control and keep it from advancing to later stages. Angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are common options used to treat heart failure. While ARNIs are a more recent development, they have also shown a lot of promise when it comes to managing heart failure.

      What are ARNIs?

      Read More
      Both ACE inhibitors and ARBs work to reduce the workload on the heart. ARNIs have a similar function.

      “ARNIs are the newest drugs that we have for treating heart failure,” Dr. Aeshita Dwivedi, a cardiologist at Lenox Hill Hospital in New York City, tells SurvivorNet. “They work similarly to the ACE [inhibitors] or the ARBs, but this actually has two different components. One is sacubitril and the other is valsartan [brand name: Entresto], so instead of one active compound, these medications have two active compounds which act synergistically to dilate your blood vessels. They also help to reduce the sodium in your body and in turn, decrease the workload in your heart.”

      Dr. Dwivedi points out that ARNIs have been effective in treating patients with heart failure in terms of reducing deaths, hospitalizations, and improving heart function.

      Side Effects of ARNIs

      Like the other treatments available for heart failure, ARNIs can cause side effects in certain individuals. The most common side effects from these drugs are:

      • Dizziness
      • Drop in blood pressure
      • Renal failure (kidney failure)
      • Increased potassium level in the blood
      • Fatigue
      • Cough
      • Allergic reactions
      • Impotence

      It’s important to let your doctor know about any side effects you experience on these drugs, so they can weigh risks vs. benefits and make any needed adjustments to your treatment plan.

      Pairing Medication with Lifestyle Adjustments

      Dr. Dwivedi also stresses the importance of adopting a healthy lifestyle when dealing with heart failure. Implementing some healthy habits into your daily routine can go a long way.

      “Your lifestyle goes a long way in dictating your life outcomes,” she says. “If you do have congestive heart failure, the underlying cornerstone of dietary changes is limiting sodium in your diet. Wherever sodium goes, water goes, the more sodium you eat, the more water your body retains and the harder it is for your heart to function with each beat. Additionally, sodium also raises your blood pressure increasing the workload on the heart.”

      In addition to cutting down on sodium (which will likely require reading food labels and making some adjustments), Dr. Dwivedi has some other suggestions as far as healthy habits go, including:

      • Staying moderately active
      • Eating a balanced diet
      • Avoiding excessive alcohol intake
      • Quitting smoking
      • Managing stress

      “It’s important to maintain an overall healthy lifestyle,” she adds, “including a healthy diet and remaining moderately active.”

      Questions to Ask Your Doctor

      • Should I consider ARNIs?
      • What are the risks vs. benefits of taking this drug?
      • Why should I take ARNIs over ACE inhibitors or ARBs?
      • What side effects should I be on the lookout for?

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