Currently, treatment options for HFpEF are limited. Several randomized controlled trials of RAAS inhibitors for HFpEF, including perindopril, candesartan, irbesartan, and spironolactone, have yielded negative results in terms of the composite end points, while candesartan may reduce the incidence of heart failure hospitalization [1]. In the TOPCAT (Heart Failure Trial with Aldosterone Antagonist for Preservation of Heart Function), an exploratory analysis revealed that patients in the Americas who received spironolactone had significant reductions in cardiovascular mortality and hospitalization for heart failure compared to those who received placebo [2].
