Sacubitril/valsartan for heart failure with preserved ejection fraction and resistant hypertension: one shot for a double strike?

This editorial refers to ‘Sacubitril–valsartan as a treatment for apparent resistant hypertension in patients with heart failure and preserved ejection fraction (HFpEF)’, by A.M. Jackson et al., doi:10.1093/eurheartj/ehab499. The management of resistant hypertension and the treatment of heart failure with preserved ejection fraction (HFpEF) still represent two burning ‘unmet needs’ in the field of cardiovascular disease.1–3 Although the prevalence of these conditions has been constantly increasing over the last decades, therapeutic strategies are frequently insufficient in spite of the continuous scientific efforts to explore new pharmacological and non-pharmacological approaches. The clinical relevance of these unresolved issues is even higher due to the close pathophysiological link between uncontrolled hypertension and HFpEF, the first contributing to the development of left ventricular (LV) hypertrophy, impaired ventricular and active atrial relaxation and filling capacities, increased cardiomyocyte passive stiffness, reduced arterial compliance, and abnormal ventricular–arterial coupling which finally lead to LV diastolic...