Current guidelines recommend the use of aldosterone antagonists
in moderate to severe heart failure (NYHA class III and IV) and in patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure.
Still, aldosterone antagonists
remain underutilized in heart failure patients in Europe as well as the United States.
Specifically, of those patients eligible, only 38 percent received a CRT device, 49 percent received an ICD, and 34 percent received aldosterone antagonist
When their pressures were measured 3-6 weeks after starting their new regimen (average of 35 days), their systolic pressure had dropped from an average of 151 mm Hg before adding the aldosterone antagonist
to an average of 144 mm Hg after, a statistically significant difference, reported Dr.
The aldosterone antagonist
spironolactone prolongs the survival of chronic heart failure patients.
Of the vast agents available, there are five major pharmaceutical categories that focus on the management of chronic heart failure: diuretics, angiotensin converting enzyme inhibitors (ACE inhibitors), angiotensin II receptor blockers (ARBs), beta blockers, and aldosterone antagonists
It has also been suggested that aldosterone antagonists
like eplerenone or spironolactone may decrease the incidence of AF in patients with congestive heart failure (16).
improve mortality but require close monitoring for severe hyperkalemia.
A-HeFT compared BiDil with placebo in black men and women with moderate to severe HF who were on standard HF therapies, including ACE inhibitors, angiotensin receptor blockers, aldosterone antagonists
, as well as digitalis and diuretics.
In the US Entresto is now a standard therapy for heart failure with reduced ejection fraction (HFrEF) as an alternative to an ACE inhibitor or an angiotensin II receptor blocker, given together with a beta blocker and an aldosterone antagonist
An aldosterone antagonist
will normalize the hypokalemia but may not be sufficient to control the elevated blood pressure, in which case a calcium channel blocker, ACE inhibitor, and/or angiotensin receptor blocker can be added.
Patients with systolic heart failure typically take an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB), a beta-blocker, an aldosterone antagonist
, a diuretic and multiple other drugs to lower blood pressure, increase blood flow and balance their body chemistry.
therapy earns the strongest possible designation in the guidelines: a Class I/Level of Evidence A recommendation.
Spironolactone HCI is a synthetic 17-lactone renal competitive aldosterone antagonist
in the class of drugs known as potassium-sparing diuretics.
All patients were started on an aldosterone antagonist
(spironolactone) on the same day as receiving their first dose of RLY5016.