Bhatt AS, Vaduganathan M, Claggett BL, et al. - Researchers undertook a large randomized clinical trial to determine how sacubitril/valsartan, relative to enalapril, could impact β-blocker and mineralocorticoid receptor antagonist (MRA) use and dosing in patients with heart failure and reduced ejection fraction. They assessed β-blocker and MRA receipt among patients randomized to sacubitril/valsartan vs enalapril through 12-month follow-up. A greater discontinuation or dose down-titration of other key guideline-directed medical therapies did not appear to be caused by sacubitril/valsartan initiation even when titrated to target dose. There were fewer discontinuations of MRA in relation to initiation of sacubitril/valsartan. Thus, sacubitril/valsartan use (vs enalapril) may encourage sustained MRA use in follow-up.