Article Abstract:
Many patients with heart failure might benefit from spironolactone. Spironolactone is a diuretic that blocks the action of aldosterone. Aldosterone is a hormone that regulates the amount of sodium, potassium, and water in the body. Congestive heart failure is characterized by excessive production of aldosterone, which causes many of the symptoms. Spironolactone blocks aldosterone. A 1999 study found that patients in heart failure who took spironolactone had lower death rates and better health than a similar group who took a placebo. This drug should be offered to all patients with heart failure.
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Article Abstract:
The Randomized Aldactone Evaluation Study (RALES) showed that, when added to standard treatment, a low dose of the aldosterone antagonist spironolactone reduced the risk of death by 30 percent over an average follow-up period of two years among carefully selected patients with current or recent heart failure of New York Heart Association (NYHA) functional class IV. Unfortunately, Juurlinket al. also shows that there was an equally brisk and striking in the number of hospital admission (and subsequent deaths) related to hyperkalemia.
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Article Abstract:
All patients with congestive heart failure should be treated with an ACE inhibitor, a loop diuretic, and an aldosterone inhibitor such as spironolactone. This combination can overcome the persistent activation of the renin-angiotensin-aldosterone system that occurs in congestive heart failure and which causes many of its symptoms.
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