Clinical Question: In congestive heart failure patients with preserved ejection fraction, does spironolactone improve cardiac outcomes?

Answer: No. A randomized controlled trial of patients with heart failure and an ejection fraction > 45% showed that spironolactone did not significantly reduce the incidence of the primary composite outcome of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for the management of heart failure. Level of Evidence for the Answer: A Limits: English, Adults, Randomized Controlled Trials, Meta-analysis, and Systematic review. Date Search Was Conducted: December 2015. Inclusion criteria: All randomized controlled trials, meta-analyses, and systematic reviews in patients with congestive heart failure with preserved ejection fractions, who were taking spironolactone, and published in the past 5 years. Exclusion criteria:; Age less than eighteen years, Eplerenone .