Spironolactone in the treatment of congestive heart failure.
OBJECTIVE
To evaluate evidence supporting the use of spironolactone in managing congestive heart failure.


METHODS
Literature accessed through MEDLINE (January 1966-December 1999) and cross-referencing of selected articles. Search terms included spironolactone and heart failure.


RESULTS
Heart failure is a leading cause of morbidity and mortality. Through aldosterone antagonism, spironolactone may be an effective pharmacotherapeutic addition to patients not responding to standard drug therapy for heart failure.


RESULTS
Clinical trials have demonstrated that, in patients with heart failure, spironolactone improves laboratory indices, quality of life, and morbidity. Recently, spironolactone has been demonstrated to improve the survival of patients with New York Heart Association (NYHA) III or IV heart failure.


CONCLUSIONS
Spironolactone use should be considered in patients with NYHA Class III or IV heart failure.
Lloyd
S J
SJ
College of Pharmacy, University of Toledo, OH 43606, USA.
Mauro
V F
VF
D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D011788:Quality of Life; D013148:Spironolactone / Q000009:adverse effects / Q000627:therapeutic use*
D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone