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Updated: Sep 8, 2025

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Sacubitril/Valsartan Reduces the Risk of All-Cause Dementia in Patients with Heart Failure: A Systematic Review and

Mohamed Mohsen Helal1, Nereen A Almosilhy2,3, Nada G Hamam4

  • 1Faculty of Medicine, Zagazig University, Zagazig, Egypt. helal.rsch@gmail.com.

Drugs & Aging
|July 29, 2025
PubMed

Insights

Sacubitril/valsartan, a heart failure medication, was found to reduce dementia risk by 15% in patients. This meta-analysis alleviates concerns about cognitive side effects, supporting its use in heart failure populations.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Pharmacology

Background:

  • Sacubitril/valsartan (ARNI) is a key heart failure (HF) treatment.
  • Concerns exist regarding ARNI's potential link to cognitive decline and dementia, specifically Alzheimer's disease, due to neprilysin inhibition.
  • Patients with HF have an elevated risk of dementia.

Purpose of the Study:

  • To evaluate the association between sacubitril/valsartan use and the risk of all-cause dementia in heart failure patients.
  • To address concerns about potential cognitive risks of sacubitril/valsartan.

Main Methods:

  • A systematic literature search was performed on March 23, 2025.
  • Included studies compared sacubitril/valsartan to placebo, no treatment, or other HF medications.
  • A random-effects model was used to pool risk ratios (RRs) and 95% confidence intervals (CIs).

Main Results:

  • Six studies (101,074 participants, 2017-2024) were analyzed.
  • Sacubitril/valsartan use was linked to a significant 15% reduction in all-cause dementia risk (RR=0.85, 95% CI: 0.74-0.98, p=0.02).
  • Sensitivity and subgroup analyses confirmed the findings' robustness.

Conclusions:

  • Sacubitril/valsartan is associated with a reduced risk of dementia in HF patients.
  • These findings mitigate concerns about cognitive adverse effects.
  • The study supports the continued use of sacubitril/valsartan as a foundational HF therapy.
Abstract

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