As valsartan can inhibit the renin–angiotensin–aldosterone system (RAAS),13,14 sacubitril/valsartan can be metabolized by liver enzymes into the active encephalinase inhibitor LBQ657, which inhibits the growth of encephalinase enzymes, reduces the degradation of natriuretic peptide, upregulates the content of natriuretic peptide, improves nitric oxide bioavailability, dilates blood vessels, reduces the cardiac load;8,14 and, prevents the release of aldosterone and renin, and myocardial hypertrophy, thus improving ventricular remodeling.13-15. This evidence concerns the gene REN and cardiac hypertrophy.