Heart failure is a serious condition where the heart is unable to pump blood effectively to meet the body’s needs. It affects millions of people worldwide and can lead to debilitating symptoms such as shortness of breath, fatigue, and fluid retention. Treatment for heart failure often involves a combination of lifestyle changes, medications, and sometimes medical devices. One medication that has shown significant promise in the treatment of heart failure is Entresto.
Entresto is a combination of two drugs, sacubitril and valsartan, which work together to improve heart function and reduce symptoms. This article explains how Entresto works to treat heart failure, its benefits, potential side effects, and how it compares to other treatments for this condition.
What Is Entresto?
Entresto is a prescription medication used to treat heart failure with reduced ejection fraction (HFrEF), a condition where the heart’s left ventricle cannot contract effectively. It was developed by Novartis and has been approved by the U.S. Food and Drug Administration (FDA) for the treatment of heart failure. Entresto combines two active ingredients:
Sacubitril: An angiotensin receptor neprilysin inhibitor (ARNI) that helps relax blood vessels and reduce fluid buildup, improving heart function.
Valsartan: An angiotensin II receptor blocker (ARB) that helps to lower blood pressure by blocking the effects of a hormone that causes blood vessels to constrict.
Together, these two components work to improve heart function, reduce symptoms, and decrease the risk of hospitalization or death related to heart failure.
How Does Entresto Work for Heart Failure?
Heart failure is often characterized by a series of complex processes in the body, including increased levels of certain hormones like angiotensin II, aldosterone, and neprilysin, all of which can contribute to the worsening of the condition.
Entresto targets and inhibits these processes to help improve heart function in multiple ways:
Inhibition of Neprilysin: Sacubitril, the first component of Entresto, works by inhibiting the enzyme neprilysin. Neprilysin breaks down important natural substances in the body called natriuretic peptides.
These peptides help regulate blood pressure, fluid balance, and kidney function. By inhibiting neprilysin, Entresto allows these natriuretic peptides to remain active in the body longer, leading to the following effects:
Vasodilation: The relaxation of blood vessels, which helps lower blood pressure and reduce the heart’s workload.
Decreased Fluid Retention: By increasing natriuretic peptides, Entresto promotes the excretion of excess sodium and water, reducing fluid retention, a common symptom of heart failure.
Reduced Aldosterone Levels: The inhibition of neprilysin helps lower the levels of aldosterone, a hormone that causes the body to retain sodium and water, contributing to swelling and fluid buildup.
Blocking Angiotensin II Effects: Valsartan, the second component of Entresto, is an angiotensin II receptor blocker (ARB).
Angiotensin II is a hormone that constricts blood vessels, increases blood pressure, and triggers the release of aldosterone.
By blocking the angiotensin II receptors, valsartan helps dilate blood vessels, reduce blood pressure, and prevent fluid retention. This improves the heart’s ability to pump blood and reduces the strain on the heart, making it work more efficiently.
Together, sacubitril and valsartan in Entresto work synergistically to improve the function of the heart, reduce fluid buildup, and help patients with heart failure live more comfortably and with less risk of serious complications.
What Are the Benefits of Entresto for Heart Failure?
Entresto offers several significant benefits for patients with heart failure. Some of the most important advantages include:
Improved Heart Function: One of the primary benefits of Entresto is its ability to improve the heart’s pumping function. By reducing fluid buildup, lowering blood pressure, and improving the dilation of blood vessels, Entresto allows the heart to pump more efficiently. This leads to improved circulation and better oxygen delivery to the body’s tissues.
Reduced Hospitalization: Heart failure is a leading cause of hospitalization, especially for older adults. Studies have shown that Entresto significantly reduces the risk of hospitalization due to worsening heart failure. By helping to stabilize the condition and prevent fluid retention, Entresto can help patients avoid the need for hospital stays.
Decreased Mortality Risk: Entresto has been shown to reduce the risk of death from heart failure. Clinical trials such as the PARADIGM-HF trial demonstrated that patients taking Entresto had a lower risk of cardiovascular death compared to those taking an ACE inhibitor, a class of drugs commonly used to treat heart failure.
Symptom Relief: Patients with heart failure often experience symptoms like shortness of breath, fatigue, and fluid retention. Entresto helps alleviate these symptoms by improving blood circulation, reducing fluid buildup, and lowering blood pressure. This results in a better quality of life for patients who struggle with the daily challenges of heart failure.
Fewer Side Effects Compared to Other Treatments: Entresto has been shown to have fewer side effects compared to other heart failure medications, such as ACE inhibitors. This makes it a suitable treatment option for patients who may experience adverse reactions to other drugs.
Potential Side Effects of Entresto
Like all medications, Entresto comes with potential side effects. Some of the common side effects include:
Low Blood Pressure (Hypotension): Because Entresto dilates blood vessels, it can lower blood pressure. In some cases, this can lead to dizziness or fainting, especially when standing up quickly. Patients should monitor their blood pressure regularly.
Elevated Potassium Levels (Hyperkalemia): Entresto may increase potassium levels in the blood, which can lead to heart arrhythmias. Regular blood tests are necessary to monitor potassium levels during treatment.
Kidney Dysfunction: In rare cases, Entresto can affect kidney function, leading to decreased kidney performance. Kidney function should be monitored through regular blood tests.
Angioedema: Although rare, Entresto can cause angioedema, a severe allergic reaction characterized by swelling of the face, lips, tongue, or throat. This condition can be life-threatening and requires immediate medical attention.
Patients taking Entresto should be aware of these potential side effects and discuss any concerns with their healthcare provider.
How Does Entresto Compare to Other Medications for Heart Failure?
Entresto is not the only medication available to treat heart failure, but it has shown to be more effective than traditional medications in some cases. For example, prior to the approval of Entresto, heart failure was commonly treated with angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, diuretics, and aldosterone antagonists. These medications help control blood pressure, reduce fluid retention, and improve heart function.
However, clinical trials have shown that Entresto, when compared to ACE inhibitors, is more effective at reducing hospitalizations and death in patients with heart failure with reduced ejection fraction (HFrEF).
The combination of sacubitril and valsartan in Entresto provides more comprehensive treatment by targeting both neprilysin and the angiotensin II receptor, which results in better outcomes for patients.
Conclusion
Entresto represents a significant advancement in the treatment of heart failure. By combining sacubitril and valsartan, this medication works in multiple ways to improve heart function, reduce fluid retention, and improve the overall quality of life for patients with heart failure. It has been shown to reduce hospitalization rates, decrease the risk of death, and provide symptom relief, making it an essential part of the treatment plan for many heart failure patients.
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