title: Aldosterone antagonists in heart failure.
abstract: Aldosterone antagonists represented by nonselective spironolactone and mineralocorticoid-selective eplerenone are approved for treatment of symptomatic heart failure with reduced systolic function. Their cardioprotective, antifibrotic, and antiarrhythmic effects have been proven in animal experiments, and their effects on morbidity and mortality have been demonstrated in randomized clinical trials. Yet, they remain the most underutilized of all classes of medications for heart failure, primarily because of fear of hyperkalemia. Thorough patient screening and selection is the key for minimizing risks and optimizing benefits from these drugs. Ongoing trials will demonstrate whether the indication for aldosterone antagonists can be expanded to less severe heart failure or patients with preserved systolic function.
authors.affiliation: University of South Florida, Tampa, FL 33647, USA. mguglin@gmail.com
authors.forename: Maya
authors.initials: M
authors.lastname: Guglin
authors.forename: Olga
authors.initials: O
authors.lastname: Kristof-Kuteyeva
authors.forename: Irina
authors.initials: I
authors.lastname: Novotorova
authors.forename: Pravin
authors.initials: P
authors.lastname: Pratap
mesh_terms: D000450:Aldosterone / Q000378:metabolism*; D000818:Animals; D000077545:Eplerenone; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D018579:Patient Selection; D012720:Severity of Illness Index; D013148:Spironolactone / Q000009:adverse effects / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000450:Aldosterone; D000077545:Eplerenone