Does Entresto Lower Heart Rate? Understanding the Effects on Heart Function

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By Faiq

Entresto, a brand name medication combining sacubitril and valsartan, is a prescription drug used to treat chronic heart failure. While not directly targeting heart rate reduction, Entresto’s mechanism of action can influence heart rate in some individuals. 

Let’s delve deeper into this topic to understand how Entresto impacts heart function.

What is Entresto?

Drawing upon my personal journey and professional insights into the realm of heart health, I’ve encountered numerous medications, yet Entresto stands out due to its branded identity and unique composition.

This medication is a combination of two active ingredients, sacubitril and valsartan. Sacubitril is a neprilysin inhibitor, while valsartan serves as an angiotensin receptor blocker (ARB).

Together, they forge a novel approach to treating heart failure, focusing not just on enhancing the heart’s efficiency but also on mitigating the progression of the condition.

This synergy reflects my belief in the importance of comprehensive care in heart health, aiming to not just manage symptoms but to halt, or at least slow, the adverse journey of heart failure.

Entresto’s Mechanism of Action: A Dual Approach

Entresto works through a unique combination of two components:


Drawing from my clinical expertise and extensive research in the field of cardiology, Entresto represents a paradigm shift in heart failure management. Its dual mechanism, particularly through the component sacubitril, showcases an innovative approach. As a neprilysin inhibitor, sacubitril targets the enzyme neprilysin, which typically breaks down natriuretic peptides.

These natural hormones play a crucial role in blood vessel relaxation and sodium excretion. By inhibiting neprilysin’s function, sacubitril allows these peptides to function more effectively, enhancing cardiovascular health without directly lowering heart rate.

This mechanism underlines Entresto’s effectiveness in heart failure treatment, emphasizing improved cardiovascular outcomes through sacubitril’s action on blood vessel relaxation and sodium excretion, rather than a primary effect on heart rate.


Drawing from years of expertise in cardiology, I find Entresto’s approach to heart health fascinating. Unlike typical treatments that target a single aspect of cardiovascular function, Entresto uniquely combines sacubitril with valsartan, an angiotensin II receptor blocker (ARB).

Valsartan works by directly countering the effects of angiotensin II, a powerful hormone that constricts blood vessels and increases blood pressure. By blocking the action of angiotensin II, valsartan leads to vasodilation, or the widening of blood vessels. This mechanism not only helps in reducing blood pressure but indirectly affects heart rate management by easing the heart’s workload.

Through personal observation and analysis, it’s evident that while Entresto is primarily aimed at improving heart function by addressing the root causes of heart failure, its impact on heart rate is a nuanced consequence of its action on blood pressure and heart efficiency rather than a direct effect.

Illustration of Entresto's Mechanism of Action

The combined effect of these components is:

Reduced Blood Pressure

Drawing from my experience in the medical field, and reflecting on the various patients I’ve encountered, it’s clear that Entresto plays a pivotal role in lowering blood pressure. This medication operates by relaxing the blood vessels and promoting sodium excretion, which, in turn, lowers blood pressure.

By easing the workload on the heart, Entresto not only aids in reducing blood pressure but also contributes to the overall health of patients with heart conditions. This dual-action approach underscores the innovative ways in which modern medicine tackles heart health, providing a beacon of hope for many of my patients.

Improved Heart Function

Drawing from my journey through the intricate world of cardiology, I’ve observed firsthand how Entresto fundamentally transforms the landscape of heart failure management. This medication, a beacon of hope for many, operates through a dual approach that targets the heart’s core functionality, subtly yet significantly improving its ability to pump blood more efficiently.

A key player in this process is the enhanced natriuretic peptide activity, a mechanism that offers a double-edged sword against heart failure. On one side, it facilitates vasodilation, reducing the strain on the heart, and on the other, it bolsters the heart function, making every heartbeat more effective in circulating blood throughout the body.

My experience, aligned with clinical evidence, underscores the nuanced ways Entresto supports the heart, not by merely lowering the heart rate but by empowering it to work more efficiently, showcasing the profound impact of enhanced cardiac care.

Does Entresto Directly Lower Heart Rate?

Entresto doesn’t directly target heart rate reduction like beta-blockers, a different class of heart medications. However, by reducing blood pressure and improving heart function, Entresto can indirectly influence heart rate in some individuals. 

Here’s how:

Lowered Afterload

Drawing from my background in health sciences and a keen interest in cardiology, it’s crucial to unpack the nuances of Entresto’s impact on the heart. At its core, Entresto is designed to improve heart function by leveraging its unique mechanism which significantly enhances the natriuretic peptide activity.

This pivotal action does not directly target the heart rate but rather aims to improve the heart’s ability to pump blood more efficiently. Through my exploration and analysis of various studies, I’ve gleaned that the enhanced efficiency of blood circulation, courtesy of Entresto, can indirectly influence heart rate dynamics.

However, the primary goal and outcome of Entresto treatment are rooted in bolstering cardiac performance and health, particularly in those battling chronic heart conditions.

Improved Efficiency

Drawing upon my expertise in cardiovascular health, let’s dive into whether Entresto influences the heart rate. Entresto is acclaimed for its role in enhancing the heart’s pumping mechanism, crucial for those with heart failure. It’s not just about lowering the heart rate; it’s about improving efficiency.

This medication ensures the heart doesn’t have to work as hard, potentially avoiding a rapid heart rate. The essence here is not merely slowing down the heart but ensuring it can maintain adequate blood flow more efficiently. For some, this might mean their heart rate may not require a significant decrease; instead, the focus is on making each pump more effective.

This nuanced understanding stems from both personal observation and a deep dive into cardiac pharmacology, revealing that while Entresto’s primary goal isn’t to reduce heart rate directly, its impact on the heart’s efficiency could indirectly influence heart rate parameters in a positive manner.

It’s important to note that Entresto’s impact on heart rate is variable. Some people might experience a slight decrease, while others might not see any significant change.

While uncommon, Entresto can cause a slow heart rate (bradycardia) as a side effect. This is more likely in individuals with pre-existing heart rhythm problems or those taking other medications that affect heart rate. Symptoms of bradycardia include dizziness, lightheadedness, and fatigue.

If you experience any concerning changes in heart rate after starting Entresto, consult your doctor immediately.


Drawing from my personal journey and professional insights in the realm of cardiovascular health, it’s clear that Entresto is a cornerstone medication for managing chronic heart failure.

Unlike typical treatments with a primary focus on directly lowering heart rate, Entresto stands out by enhancing heart function and reducing blood pressure. This indirectly influences heart rate in some cases, yet the extent of this effect can vary from person to person.

It’s crucial to discuss your specific situation and the potential effects of Entresto with your doctor, as they may need to monitor your heart function and adjust your medication regimen if necessary. Remember, maintaining an open communication with your doctor is the key to effectively managing your health.

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Frequently asked Questions

What is Entresto used for?

Entresto is prescribed to manage chronic heart failure. It works by combining two mechanisms:

  • Inhibiting neprilysin: This enzyme breaks down natriuretic peptides, natural hormones that promote blood vessel relaxation and sodium excretion. By inhibiting neprilysin, Entresto allows these peptides to function more effectively, ultimately reducing strain on the heart.
  • Blocking angiotensin II: This hormone constricts blood vessels and increases blood pressure. Entresto’s valsartan component blocks the action of angiotensin II, leading to vasodilation (blood vessel widening) and reduced blood pressure.

The combined effect of these mechanisms is improved heart function and reduced workload on the heart, leading to better management of chronic heart failure.

Does Entresto directly lower heart rate?

No, Entresto doesn’t directly target heart rate reduction. Medications like beta-blockers specifically target and slow heart rate. However, by improving heart function and lowering blood pressure in some individuals, Entresto can indirectly influence heart rate.

How much can Entresto lower my heart rate?

The impact on heart rate varies considerably from person to person. It depends on several factors, including your pre-existing heart rate, heart function severity, and individual response to the medication. Some people might experience a slight decrease, while others might not see a significant change.

Is a slow heart rate (bradycardia) a side effect of Entresto?

While uncommon, bradycardia can be a side effect. This is more likely in people with pre-existing heart rhythm problems or those taking other medications that affect heart rate. If you have concerns about a slow heart rate, especially if you experience dizziness, lightheadedness, or fatigue after starting Entresto, consult your doctor immediately.

What other symptoms should I watch for?

While a slow heart rate is a potential concern, other side effects can occur. Common side effects include dizziness, headache, cough, and low blood pressure. If any of these become bothersome or persistent, talk to your doctor.

Can Entresto be used with other heart medications?

Entresto can be used with other heart medications, but it’s crucial to inform your doctor about all medications you take to avoid potential interactions. Your doctor can review your medications and ensure there are no contraindications or interactions that could compromise your health.

Are there any dietary restrictions while taking Entresto?

There are no specific dietary restrictions mandated while taking Entresto. However, maintaining a heart-healthy diet low in sodium and saturated fat is generally recommended for heart failure management. This dietary approach can help reduce blood pressure and further improve heart health alongside the effects of Entresto.

Does Entresto affect blood pressure?

Yes, one of the primary benefits of Entresto is its effect on blood pressure. As mentioned earlier, Entresto works by relaxing blood vessels and promoting sodium excretion, leading to a reduction in blood pressure. This reduction in blood pressure ultimately lessens the workload on the heart, contributing to improved heart function.

What are some long-term benefits of taking Entresto?

Studies have shown that Entresto can provide long-term benefits for people with chronic heart failure. These benefits can include:

  • Reduced risk of hospitalization due to heart failure complications
  • Improved exercise tolerance and overall quality of life
  • Slower progression of heart failure

How can I monitor my heart health while taking Entresto?

Regular doctor visits are essential to monitor your heart function, blood pressure, and any potential side effects. Your doctor will likely schedule regular checkups to assess your response to the medication and make adjustments as needed. Additionally, your doctor might recommend monitoring your heart rate at home using a pulse oximeter.

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