Spironolactone Dose in Heart Failure with Preserved Ejection Fraction: Findings from TOPCAT

Abstract

Spironolactone (but not placebo) was used at lower doses among the elderly, those with renal dysfunction and with higher potassium levels. The effect of spironolactone was homogeneous across these subgroups. In patients unable to tolerate target doses, a low-dose strategy should be preferred to stopping treatment.