Effectiveness, Safety and Use of Sacubitril/valsartan in Patients with Heart Failure with Preserved Ejection Fraction
Main Article Content
Abstract
Currently, sacubitril/valsartan is used in the treatment of heart failure with reduced ejection fraction (HFrEF). It shows efficacy in reducing mortality from cardiovascular disease and lowering the rate of hospital readmissions due to heart failure. According to current heart failure treatment guidelines, this drug can also be considered as an alternative therapy for patients with heart failure with preserved ejection fraction (HFpEF). It has been shown to reduce N-terminal pro b-type natriuretic peptide (NT-proBNP) levels, thereby improving patients’ symptoms. However, safety in its use should be carefully considered. Adverse effects of sacubitril/valsartan include orthostatic hypotension and hyperkalemia. Therefore, its use should be closely monitored in terms of efficacy, safety, and appropriateness of use to ensure optimal therapeutic outcomes and patient safety.
Article Details

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
References
Bozkurtet B, Ahmad T, Alexander K, Baker W, Bosak K, Breathett K, et al. Heart failure epidemiology and outcomes statistics: A report of the Heart Failure Society of America. J Card Fail 2023; 29: 1412-51.
Borlaug Barry A, Sharma K, Shah Sanjiv J, Ho Jennifer E. Heart failure with preserved ejection fraction: JACC scientific statement. J Am Coll Cardiol 2023; 81: 1810-34. doi: 10.1016/j.jacc.2023.01.049.
Feng J, Zhang Y, Zhang J. Epidemiology and burden of heart failure in Asia. JACC. Asia. 2024; 4: 249–64.
Jiampo P, Tangkittikasem T, Boonyapiphat T, Senthong V, Torpongpun A. Real-world heart failure burden in Thai patients. Cardiol Ther 2024; 13: 281-97.
McDonagh T, Metra M, Adamo M, Gardner R, Baumbach A, Böhm M, et al. 2023 Focused Update of the 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023; 44: 3627-39.
Heidenreich P, Bozkurtet B, Aguilar D, Allen L, Byun J, Colvin M, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation 2022; 145: e895-e1032.
Kittleson M, Panjrath G, Amancherla K, Davis L, Deswal A, Dixon D, et al. 2023 ACC expert consensus decision pathway on management of heart failure with preserved ejection fraction: A report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol 2023; 81: 1835–78.
MIMS Thailand. Tolvaptan [online] 2025 [cited Jul 20, 2025]Available from: www.mims.com/thailand/drug/ info/tolvaptan?mtype=generic
Entresto [package insert]. East Hanover, NJ: Novartis Pharmaceuticals Corporation; 2024.
Solomon S, McMurray J, Anand I, Ge J, Lam C, Maggioni A, et al. Angiotensin–neprilysin inhibition in heart failure with preserved ejection fraction. N Engl J Med 2019; 381:1609-20.
Mentz R, Ward J, Hernandez A, Lepage S, Morrow D, Sarwat S, et al. Angiotensin-neprilysin inhibition in patients with mildly reduced or preserved ejection fraction and worsening heart failure. J Am Coll Cardiol 2023; 82: 1–12.
Nouhravesh N, Cyr D, Hernandez A, Morrow D, Velazquez E, Ward J, et al. In‐hospital or out‐of‐hospital initiation of Sacubitril/valsartan versus valsartan in patients with mildly reduced or preserved ejection fraction after a worsening heart failure event: The PARAGLIDE‐HF Trial. J Am Heart Assoc. 2025; 14: e037899.