Fig. 1

Summary of the effect of sacubitril/valsartan and AD risk. Neprilysin inhibition (sacubitril) may lead to both a potential and theoretical protective pathway (e.g., enhancing neuroprotective neuropeptide Y (NPY), substance P (SP), and glucagon-like peptide 1 (GLP-1), and improving heart function - green text in the figure) and a pathway potentially/theoretically increasing the risk of AD (e.g., reducing Aβ clearance, elevating bradykinin (BK), and natriuretic peptides (NP)… - orange text in the figure) [7]. To date, there is no clinical evidence in humans indicating an elevated risk of cognitive decline or Alzheimer’s disease during treatment, but there are alterations in amyloid blood-based biomarkers (blue text in the figure). Image Heart & Brain generated/drawn by AI (https://www.craiyon.com), and edited by A.G-C.