Aldosterone antagonists, in heart failure

The benefits of aldosterone antagonists in heart failure appear to be due largely to their neurohormonal inhibition, namely, inhibition of aldosterone s actions in the heart. Specifically, the benefits are believed to be due to the ability of these agents to inhibit aldosterone-mediated cardiac fibrosis and thus ventricular remodeling. And while spironolactone historically has been viewed as a diuretic, this is believed to contribute little to its benefits in heart failure in part because the doses used have minimal diuretic effect. Thus, as with ACE inhibitors and /S-blockers, the data on aldosterone antagonists also support the neurohormonal model of heart failure. 

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