Spironolactone is an aldosterone antagonist, which is approved and used for treatment of systolic heart failure. In a study with diastolic heart failure patients referred to as TOPCAT trial, spironolactone was shown to decrease the rate of hospitalizations, but none of the other study endpoints including mortality. The CDC estimates that 5.7 million Americans have heart failure. It is also the most common cause of hospital admissions in the Medicare population, and diastolic heart failure accounts for half of all heart failure cases. Despite the high health care expenditure due to these hospitalizations, there is currently no effective pharmacotherapy for diastolic heart failure. How often do you see patients with diastolic heart failure in your practice? What medication regimen are they stabilized on?
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