Secondary analysis of the cohort described in the landmark Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial showed a median decrease of NT-pro-BNP of 28% after the first 8–10 weeks of treatment.16 Furthermore, the proportion of patients in which the treatment was limited by symptomatic hypotension, hyperkalaemia or a decline in renal function in the PARADIGM- HF trial was low.11 In the current cohort, the median decrease in NT-pro-BNP was 45% after 6 months of treatment. The gene discussed is NPPB; the disease is heart failure.