These studies have all been excluded within this review, because they no longer meet the review protocol. For further explanation please refer to the excluded clinical studies table (appendix I) and the Recommendations and link to evidence Table 41: Summary of studies included in the review Study Intervention and comparison Population Outcomes Comments Aldo-DHF Edelmann Intervention: Spironolactone (25 mg / day) Comparison: Placebo People aged 50 years with chronic NYHA class II or III heart failure, preserved LVEF 50%, and evidence of diastolic dysfunction/atrial fibrillation. 72% on BB, 77% on ACEI or ARB. Mortality Quality of life (SF- Functioning, Minnesota Living with Heart Failure Questionnaire) Hospitalisation Adverse events (gynaecomastia, hyperkalaemia, renal function) NYHA class Length of follow up: 1 year. SF-36 global self- assessment, Patient Health Questionnaire depression scale, and Hospital Anxiety and Depression Scale were also reported in study but have not been extracted as validated quality of life measures were also reported. TOPCAT Intervention: Spironolactone (15 45 mg / day) Comparison: Placebo People aged 50 years with symptomatic heart failure and LVEF 45%. 78% on BB, 84% on ACEI or ARB. Mortality Quality of life Kansas City Cardiomyopathy Questionnaire) Hospitalisation Adverse events (gynaecomastia, hyperkalaemia, renal function) Length of follow up: 3.3 years. McMaster Overall Treatment Evaluation instrument was also used to assess quality of life but was not been extracted as validated quality of life measures were also reported. Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. 