Spironolactone in left-sided heart failure: How does it fit in?

The familiar diuretic spironolactone has taken on new life as a treatment f or left-sided congestive heart failure. Spironolactone has been shown to de crease mortality in such patients who are New York Heart Association class IV. It can be used in addition to agents such as angiotensin-converting enz yme inhibitors and beta blockers, which also decrease mortality, and diuret ics and digoxin, which are useful in treating symptoms. Spironolactone is s afe, easy to use and reasonably priced. More research is necessary to deter mine the order and combinations of these medications in slowing the progres sion of this disease.