Aldosterone Antagonist for Treatment of HFpEF

Panelists revisited the role of aldosterone antagonists in heart failure with preserved ejection fraction (HFpEF), underscoring their importance in reducing fibrosis, remodeling, and congestion. Despite mixed evidence in earlier trials, these agents remain key components of modern therapy.

The conversation explored clinical experience with finerenone and spironolactone, noting that both improve functional outcomes when used appropriately. Patient selection and close laboratory monitoring were identified as crucial to maximizing benefit and minimizing risk.

Panelists concluded that aldosterone antagonists are most effective when integrated with broader guideline-directed regimens, reinforcing their place in comprehensive HFpEF management.