ACE and hydrops fetalis: A further distinguishing feature is the choice of comparator agent; unlike PARADIGM‐HF and PARADISE‐MI that used an ACE inhibitor (enalapril and ramipril, respectively), in the present trial, the use of valsartan at the dose shown to be as efficacious as captopril (target dose 50 mg three times daily) in the VALIANT will allow us to precisely define the effects of neprilysin inhibition per se without the uncertainty about comparing renin angiotensin system blockade with an ACE inhibitor, compared with an ARB.