Role of Angiotensin Receptor-Neprilysin Inhibitor in Essential Hypertension, Heart Failure with Reduced Ejection Fraction Andchronic Kidney Disease

This Hypertension is the potential risk factor and the most common co-morbidity in heart failure and chronic kidney disease. The interdependence that exists between heart and kidney disorders (cardiorenal syndrome) is associated with hypertension.Inhibition of rennin Aldosterone Angotensin sytem (RAAS) and Sympathetic nervous system is the cornerstone in the management of hypertension, heartfailure with reduced ejection fraction and chronic kidney disease. Angiotensinin receptor-neprilys in inhibitor (ARNI) is the novel drug, carries dual-acting inhibition, as it inhibits both RAAS and the Natriuretic Peptide System(NPS). (ARNI) has shown to be effective by reducing cardiovascular mortality by 20% as compared to RAAS inhibition monotherapy in patients with chronic heart failure with reduced ejection fraction. Hence, this agent is suitable for the management of above diseases. Despite of potential benefits, the uptake of ARNI In real world has remained to be low and there is paucity of data of treatment with ARNI in people with chronic heart failure with reduced ejection fraction especially in concomitant with hypertension or chronic kidney disease. This review summarizes the reported evidences regarding the use of ARNI in the treatment of hypertension, chronic heart failure with reduced ejection fraction and chronic kidney disease.