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16,27 Steroidal MRAs (e.g., spironolactone and eplerenone) carry a Class 2a recommendation in both the AHA and JCS/JHFS guidelines and may reduce HF hospitalizations in selected subsets of patients with HFpEF, whereas the European Society of Cardiology (ESC) guidelines do not provide specific recommendations for their use in this population

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While improved glucose metabolism and weight loss matter, a large portion of the benefit appears to stem from direct or indirect anti-inflammatory effects that are independent of those metabolic changes

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[DOI] [PubMed] [Google Scholar] 23.Inoguchi T, Li P, Umeda F, Yu HY, Kakimoto M, Imamura M, et al