04 - Heart Failure (Part 3): GDMT and Spironolactone

In this episode of Key Perspectives, we continue our heart failure series by diving into Part 3: Medication Management, with a focus on spironolactone, a cornerstone of guideline-directed medical therapy (GDMT).

We start by reviewing the distinctions between HFpEF, HFmrEF, and HFrEF, and discuss how treatment strategies differ across these subtypes. The hosts explain what GDMT is, who develops it, and why it's essential in improving outcomes and reducing hospitalizations in heart failure patients.

The spotlight is on spironolactone—its dual role in HFrEF and HFpEF, its mechanism as a mineralocorticoid receptor antagonist, and how it contributes to diuresis, cardiac remodeling prevention, and potassium-sparing benefits. We also cover clinical pearls, including when it can be used alongside loop diuretics like Lasix, and important considerations for avoiding use in patients with hyperkalemia or poor renal function.

Tune in for a concise, clinically relevant discussion that enhances your understanding of heart failure pharmacology and supports your practice in geriatric and complex patient care settings.