Expert Opinion on the Potential Role of Angiotensin Receptor-neprilysin Inhibitors in Managing Hypertension

Hypertension is the primary cause of cardiovascular disease, affecting 1.1 billion individuals globally, with only 20% having controlled blood pressure. In India, hypertension is the leading risk factor for chronic diseases, especially among rural and younger populations. Angiotensin receptor-neprilysin inhibitor (ARNI) has been demonstrated to be a safe and effective treatment for hypertension. Despite the substantial body of literature and research on the use of ARNI for hypertension, there are no formal recommendations for its real-world application, and its use in hypertension management remains questionable. To address this gap, 11 advisory board meetings were conducted across India, each involving 12–15 cardiologists. These meetings, guided by a literature review (PubMed and Google Scholar), focused on evaluating the efficacy of ARNI in treating hypertension across different patient groups and comparing it with other treatments. This review article summarizes the clinical evidence supporting the role of ARNI in the management of hypertension. In addition, it includes a compilation of discussions and expert opinions from these meetings on the future prospects of ARNI in difficult-to-control or resistant hypertension, regardless of heart failure symptoms.