What are the recommended measurements for monitoring the treatment of chronic heart failure?
Before and after starting an MRA and after each dose increment, it is recommended to measure serum sodium and potassium and assess renal function, measure blood pressure, and monitor treatment monthly for 3 months and then at least every 6 months. Additionally, relative values of different outcomes such as all-cause mortality, quality of life, and all-cause hospitalisation are considered important for decision-making. These should be assessed at any time the person becomes acutely unwell. It is also important to monitor for specified adverse events, such as hyperkalaemia, renal function, hypotension, and gynaecomastia. Evidence was identified for all outcomes except for quality of life. The evidence for eplerenone and spironolactone was analysed together for all outcomes except for gynaecomastia, where the 2 interventions were analysed separately due to gynaecomastia being a common adverse effect of spironolactone but an uncommon effect of eplerenone.