<unk>  can be used instead of an ACE inhibitor or an angiotensin receptor blocker in people with heart failure and a reduced left ventricular ejection fraction (LVEF), alongside other standard therapies (e.g. beta-blockers) for heart failure. To investigate its use for heart failure in those with a preserved LVEF (HFpEF), Novartis funded the PARAGON-HF trial which was designed to investigate the use of<unk>  in the treatment of HFpEF patients with a LVEF of 45% or more. Concluding in 2019, it failed to show significance for reducing hospitalisation related to heart failure or reducing death from cardiovascular causes, and therefore appearing to show limited benefit to those with HFpEF. A Cochrane systematic review of data from 37 trials investigating treatments for HFpEF suggested that evidence is also lacking to support the use of ACE Inhibitors, ARBs or ARNIs in patients with HFpEF at this time, and that the mainstay pharmacological therapy for HFpEF still remains the treatment of co-morbidities such as hypertension or other triggers for decompensation. Patients who exhibit symptoms of NYHA Class II or III heart failure and are still symptomatic despite maximally tolerated dose of an ACE inhibitor or ARB alone, may be considered for<unk>  dual therapy to decrease the risk of cardiovascular-related and all-cause mortality. Mortality benefits have only been observed to date in those with LVEF less than 35%. Changing 100 people from an ACE inhibitor or angiotensin II receptor antagonist to<unk>  for 2.3 years would prevent three deaths, five hospitalizations for heart failure, and eleven hospitalizations overall.
Sacubitril/valsartan
Telmisartan/amlodipine
Lisinopril/amlodipine
Amlodipine/atorvastatin
Olmesartan/amlodipine
Amlodipine/valsartan
Enalapril/hydrochlorothiazide
Amlodipine/benazepril