Why the study?
Does a low-dose spironolactone strategy maintain its effect compared to target doses in patients with heart failure with preserved ejection fraction?
Does a low-dose spironolactone strategy maintain its effect compared to target doses in patients with heart failure with preserved ejection fraction?
In HFpEF patients unable to tolerate target doses of spironolactone, a low-dose strategy maintains a homogeneous treatment effect and should be preferred to stopping treatment.
May support continuing low-dose over stopping in intolerant HFpEF patients; leaves open RCT confirmation.
Spironolactone (but not placebo) was used at lower doses among the elderly, those with renal dysfunction and with higher potassium levels. The effect of spironolactone was homogeneous across these subgroups. In patients unable to tolerate target doses, a low-dose strategy should be preferred to stopping treatment.
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Ferreira et al. (2020) studied this question.
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