A novel therapy for heart failure is the Angiotensin Receptor Nepriysin Inhibitors. These agents are combinations of the angiotensin receptor blocker (ARB) valsartan and the Neprilysin inhibitor, sacubitril. As Neprilysin degrades natriuretic peptides, its inhibitors prolong the effects of natriuretic peptides. These effects include increased natiuresis and a. reduction in blood pressure. This is in combination with an ARB which also reduces afterload. ARNIs have been shown in clinical trials to improve clinical outcomes including death from cardiovascular disease or hospitalization for heart failure when compared to lisinopril. ARNIs have been shown to be beneficial in patients with Acute Decompensated Heart Failure (ADHF). Consequently, ARNIs are recommended in ACC/AHA and ESC guidelines for the management of patients with heart failure with reduced ejection fraction (HFpEF) including in patients who remain symptomatic with ARBs and angiotensin converting (ACE) inhibitors.