ACE and hydrops fetalis: The PARADIGM-HF trial, a prospective comparison of neprilysin (NEP) inhibitors versus angiotensin-converting enzyme (ACE) inhibitors, demonstrated that sacubitril/valsartan significantly reduced the risk of cardiovascular death and all-cause mortality in patients with heart failure and reduced ejection fraction, and also showed a significantly lower decline in renal function, suggesting that it may have a renoprotective effect.