Spironolactone did not significantly reduce deaths in patients with heart failure and preserved ejection fraction, however it did cut hospitalisations for heart failure, the TOPCAT study has shown. This was an international, multicentre, randomised, double-blind trial of patients with symptomatic heart failure and left ventricular ejection fraction ≥ 45%. A total of 3,445 patients were randomised to receive either spironolactone (15 to 45 mg daily) or placebo. The mean age of patients was 68.7 in both groups.