![]() The Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) study was an international, randomized, double-blind, placebo-controlled trial. Recent evidence, however, advocates for the use of aldosterone antagonists, such as spironolactone in HFpEF. 3 This includes the cornerstone of HFrEF therapy angiotensin converting enzyme (ACE) inhibitors, as well as angiotensin receptor blockers (ARBs) or beta blockers. Pharmacologic therapies have not been shown to improve mortality in HFpEF, unlike therapies in HFrEF. 3 About 50% of all heart failure patients have preserved ejection fraction defined as an ejection fraction ≥50%. 2 The mortality and hospitalization rates are fairly similar for patients with heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF). Of the patients newly diagnosed with heart failure, about 50% will not survive more than 5 years. 1 Heart failure is a main contributor to cardiac-related mortality. 1 cause of mortality in the western world, including the United States. Cardiovascular disease continues to be the No.
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