What evidence was available regarding the effects of MRAs on mortality and hospitalisation?
There was moderate quality evidence estimating 13 fewer deaths per 1000 patients and high quality evidence estimating 12 fewer hospitalisations per 1000 patients per year in people taking mineralocorticoid receptor antagonists (MRAs), however, the confidence intervals were mostly indicating benefit but also had indication of increased mortality and hospitalisation. There was also moderate quality evidence (from a smaller study that did not report number of events) that suggested an increase in the number of patients hospitalised for any cause in the intervention group compared to the placebo group, though this evidence was imprecise. It was unclear whether MRAs have a clinical benefit, a clinical harm, or no effect on mortality and hospitalisation in this population.