
As sacubitril/valsartan may potentiate early natriuresis, expert consensus documents recommend diuretic dose reduction on first initiation. However, there are limited data on the effects of sacubitril/valsartan on the background of varying diuretic regimens or on diuretic requirements over time in heart failure (HF) with preserved ejection fraction (HFpEF). Patients with HFpEF on higher baseline diuretic doses were at heightened risk of HF events but similarly benefited from sacubitril/valsartan with a consistent safety profile across a range of diuretic doses. In addition, initiation of sacubitril/valsartan was associated with a modestly lower new loop diuretic requirement in follow‐up.
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