Incidence of Hypotension and Clinical Characteristics After the Introduction of Angiotensin Receptor-Neprilysin Inhibitors in Patients With Acute Decompensated Heart Failure　― Effects on Cardiac Rehabilitation ―

Abstract

Background: To examine hypotension during cardiac rehabilitation (CR) after angiotensin receptor-neprilysin inhibitor (ARNI) initiation in patients with acute decompensated heart failure (ADHF) and its clinical characteristics.

Methods and Results: We studied 124 ADHF patients who received ARNI (2022–2023). During CR, 26.6% had systolic blood pressure (SBP) <90 mmHg; 54.5% experienced interruption or difficulty mobilizing. ARNI were discontinued because of hypotension in 24.2% of patients. Logistic regression revealed low preARNI SBP and high B-type natriuretic peptide (BNP) levels as predictors.

Conclusions: Low SBP during CR after ARNI use occurred in 26.6% of patients and was associated with low preARNI SBP and high BNP levels.