ARNIs produce which of the following effects?

• A. They widen blood vessels, remove excess sodium and fluid, lower blood pressure, and reduce stress on the heart
• B. They narrow blood vessels and increase fluid retention
• C. They increase heart rate and cause hypertrophy
• D. They have no effect on blood pressure

Answer: (A)

ARNIs work by combining neprilysin inhibition with angiotensin receptor blockade. Inhibiting neprilysin raises levels of natriuretic peptides, which promote vasodilation, natriuresis (sodium loss), and diuresis (fluid loss), helping to reduce preload. The angiotensin receptor blockade prevents angiotensin II–mediated vasoconstriction and aldosterone release, further lowering afterload and fluid retention. Altogether, these actions lower blood pressure and lessen the workload on the heart. So the effect described—widening vessels, removing excess sodium and fluid, lowering blood pressure, and reducing stress on the heart—is the best match.