[Infographics] ARNI for hypertension: Clinical trial data & Asian guideline recommendations

The angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan is approved for treatment of essential hypertension in addition to its well-established indication in heart failure with reduced ejection fraction (HFrEF). On top of effective blood pressure (BP) lowering, clinical trial data also demonstrated reversed cardiac remodelling in Asian patients with hypertension and left ventricular hypertrophy (LVH) treated with sacubitril/valsartan vs valsartan, while patients with chronic kidney disease (CKD) showed greater BP reduction and comparable renal outcomes with sacubitril/valsartan vs irbesartan. The Japanese Society of Hypertension Guidelines 2025 recommend ARNI as step 2 or step 3 treatment, highlighting its role in hypertension management in patients with comorbidities, including cardiac hypertrophy, CKD and HF.