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Aldosterone Antagonists

The Most Underutilized Class of Heart Failure Medications

  • Original Research Article
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American Journal of Cardiovascular Drugs Aims and scope Submit manuscript

Abstract

Background

Aldosterone antagonists have been proven to be beneficial in severe heart failure (HF) as a result of systolic dysfunction. We sought to determine if there is a disparity in their utilization compared with ACE inhibitors and β-adrenoceptor antagonists (β-blockers).

Methods

In the first part of the study, we asked physicians to answer a questionnaire presenting a hypothetical HF patient. In the second part, we reviewed hospital charts of patients with HF exacerbation.

Results

Spironolactone was used less frequently than other drugs. At home, 75.0% of patients were receiving ACE inhibitors, 66.7% received β-blockers, and 38.2% received spironolactone (p < 0.001). During the admission, 93.1% of patients received ACE inhibitors and 58.3% received spironolactone (p < 0.001).

Conclusions

Despite good evidence, underutilization of aldosterone antagonists in patients matching the population of the RALES (Randomized Aldactone Evaluation Study) trial persists in both outpatient and inpatient settings. The difference between the usage of ACE inhibitors and spironolactone is significant in patients with systolic dysfunction equally qualifying for both medications.

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Acknowledgments

No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Wayne State University/Harper Hospital, 3990 John R. Street, Detroit, MI, 48201, USA

    Maya Guglin, Khaled Esmaeel Awad, Latha Polavaram & Hema Vankayala

Authors
  1. Maya Guglin
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  2. Khaled Esmaeel Awad
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  3. Latha Polavaram
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  4. Hema Vankayala
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Correspondence to Maya Guglin.

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Guglin, M., Awad, K.E., Polavaram, L. et al. Aldosterone Antagonists. Am J Cardiovasc Drugs 7, 75–79 (2007). https://doi.org/10.2165/00129784-200707010-00007

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  • DOI: https://doi.org/10.2165/00129784-200707010-00007

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