Fig. (6) Explanation. Sacubitril/valsartan contains valsartan and sacubitril (neprilysin inhibitor) = LBQ657. Neprilysin changes ANP, BNP, CNP, adrenomedullin, substance P, bradykinin, angiotensin II, etc., into inactive fragments, whereas Sac/Val increases them. On the other hand, angiotensin long blockade induces aldosterone through the aldosterone breakthrough and increases the blood pressure. Increased aldosterone and blood pressure cause renal tubule fibrosis, glomerular fibrosis and injury, and sacubitril/valsartan decreases them.