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Previous Volume 342:132-134 January 13, 2000 Number 2 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: The study by Pitt and colleagues (Sept. 2 issue)¹ of the effect of spironolactone on morbidity and mortality in patients with severe heart failure addresses a very important issue. Spironolactone, a relatively inexpensive and safe agent, has not previously been shown to increase the value of triple therapy with an angiotensin-converting–enzyme (ACE) inhibitor, furosemide, and digoxin. We have not used it because of concern that it may precipitate serious hyperkalemia.

We are concerned, however, that the practical message of this study — that is, that spironolactone can decrease morbidity and mortality in patients with severe heart failure . . . [Full Text of this Article]

References

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• MacDonald, M. R., Petrie, M. C., Hawkins, N. M., Petrie, J. R., Fisher, M., McKelvie, R., Aguilar, D., Krum, H., McMurray, J. J.V. (2008). Diabetes, left ventricular systolic dysfunction, and chronic heart failure. Eur Heart J 29: 1224-1240 [Abstract] [Full Text]  
• Weinberg, M. S, Weinberg, A. J, Zappe, D. H (2000). Effectively targetting the renin-angiotensin-aldosterone system in cardiovascular and renal disease: rationale for using angiotensin II receptor blockers in combination with angiotensin-converting enzyme inhibitors. Journal of Renin-Angiotensin-Aldosterone System 1: 217-233