What diet is recommended to maximize the effectiveness of Entresto (sacubitril/valsartan)?

From the Guidelines

To maximize the effectiveness of Entresto, patients should follow the DASH diet, which emphasizes high intakes of fruits, vegetables, low-fat dairy, and whole grains, as it has been shown to effectively reduce blood pressure and prevent heart failure. This dietary approach is supported by a scientific statement from the American Heart Association, which highlights the importance of dietary interventions in the prevention of heart failure 1. The DASH diet is characterized by high potassium, magnesium, calcium, and fiber, moderately high protein, and low total and saturated fat, making it an ideal choice for patients taking Entresto.

Some key components of the DASH diet include:

• High intake of fruits and vegetables, which are rich in potassium, magnesium, and calcium
• Low-fat dairy products, which provide calcium and protein
• Whole grains, which are rich in fiber, magnesium, and potassium
• Lean proteins, such as poultry and fish, which are low in saturated fat
• Healthy fats, such as those found in nuts and seeds, which are rich in monounsaturated and polyunsaturated fats

In addition to following the DASH diet, patients taking Entresto should also:

• Limit their sodium intake to less than 2,000 mg daily to reduce fluid retention
• Stay well-hydrated but avoid excessive fluid intake, especially if they have fluid retention issues
• Monitor their potassium intake carefully, as Entresto can affect potassium levels, and include moderate amounts of potassium-rich foods like bananas and potatoes
• Limit alcohol consumption and maintain a stable weight through regular physical activity as tolerated.

It is essential to note that while the Mediterranean diet has also been shown to prevent cardiovascular events, the DASH diet is specifically recommended for its effectiveness in reducing blood pressure and preventing heart failure, making it the ideal choice for patients taking Entresto 1.

From the Research

Diet Recommendations for Entresto (Sacubitril/Valsartan) Effectiveness

There is limited direct evidence on the specific diet recommended to maximize the effectiveness of Entresto. However, some studies provide insights into the potential benefits of certain dietary approaches:

• A high-protein diet was used in a study on rats with cardiorenal syndrome, where Entresto was found to offer protection against heart and kidney damage 2.
• There is no direct evidence on the optimal diet for patients taking Entresto, but a healthy diet is generally recommended for patients with heart failure.

Key Considerations

When considering dietary recommendations for patients taking Entresto, the following points are important:

• Entresto has been shown to be effective in improving heart failure outcomes, regardless of dietary factors 3, 4.
• Patients with heart failure and diabetes may benefit from the use of SGLT2 inhibitors or ARNI, such as Entresto, to reduce the risk of atherosclerotic cardiovascular disease 5.
• A balanced diet that is low in sodium, added sugars, and saturated fats, and high in fruits, vegetables, and whole grains, is generally recommended for patients with heart failure.

Potential Interactions

Some dietary components may interact with Entresto or affect its efficacy:

• High-protein diets may affect kidney function, which is a consideration for patients taking Entresto 2.
• Patients taking Entresto should be monitored for potential side effects, such as hypotension and angioedema, which may be affected by dietary factors 4.