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Spironolactone improved outcomes in patients with severely symptomatic HF with reduced ejectionfraction, and later, eplerenone expanded the benefits to patients with mildly symptomatic HF with reduced ejectionfraction and myocardialinfarction complicated by HF.
4] More recently, at least at the epidemiologic level, the obesity paradox has been confirmed in both heart failure with reduced ejectionfraction (HFrEF) and heart failure with preservedejectionfraction (HFpEF), but also in those with coronary heart disease. [5, Carbone, Salvatore, et al. 2017): 451-463.
Additionally, 10% of the global population suffers from chronic kidneydisease , with diabetes and hypertension as significant risk factors. Disparities in care are also concerning, with diagnosed cardiometabolic diseases varying up to twofold among different racial and ethnic groups. In the U.S.,
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