Entresto and heart rate?

Short answer: Entresto (sacubitril/valsartan) doesn’t directly slow or speed the heart rate, but it can affect heart rate indirectly by lowering blood pressure and improving heart failure symptoms. In big studies, resting heart rate changes were small and not a major difference compared with other therapies.

What to know about heart rate with Entresto
- You may notice BP changes more than a direct change in heart rate. If blood pressure drops a lot, you might feel lightheaded or dizzy, and your heart rate could respond accordingly.
- Heart rate is also influenced by other medicines you might be taking (e.g., beta-blockers) or by your HF status.
- Entresto can cause hypotension (low blood pressure), which might lead to reflex changes in heart rate for some people.

What to monitor
- Resting heart rate and blood pressure at home, especially after starting Entresto or changing dose.
- Any symptoms: dizziness, fainting, palpitations, chest pain, or unusual fatigue.
- Kidney function and potassium, since Entresto can affect these and sometimes indirectly influence how you feel overall.

When to seek medical help
- Very slow heart rate (e.g., symptoms like fainting, extreme dizziness) or very fast/pounding heart rate with symptoms.
- Severe dizziness, fainting, chest pain, or any concerning symptoms.
- If you notice a big drop in blood pressure, or you’re unsure about symptoms, contact your clinician promptly.

A few practical notes
- Do not switch directly from an ACE inhibitor to Entresto without a doctor’s guidance (usually there’s a 36-hour washout period).
- If you’re taking a beta-blocker or other meds that slow the heart, talk to your doctor about how Entresto might interact with heart rate.

If you’d like, tell me:
- Are you currently on Entresto? What dose?
- What’s your average resting heart rate and blood pressure?
- Are you taking other meds that affect heart rate (like a beta-blocker)?
Then I can tailor the info to your situation.