MODERATEc due to risk of bias The mean quality of life (minnesota) in the control groups was The mean quality of life (minnesota) in the intervention groups was (3.54 lower to 3.54 higher) Quality of life (SF-36 Physical Functioning) SF-36 Physical Functioning scale MODERATEc due to risk of bias The mean quality of life (sf-36 physical functioning) in the control groups was The mean quality of life (sf-36 physical functioning) in the intervention groups was (6.61 lower to 2.61 higher) Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: Outcomes No of Participants (studies) Follow up Quality of the evidence (GRADE) Relative effect Anticipated absolute effects Risk with Placebo Risk difference with Mineralocorticoid receptor antagonist (95% CI) All-cause hospitalisation (count rate) 3445 HIGH Rate Ratio 200 events per 1000 person- years 12 fewer events per 1000 person- years (from 26 fewer to 4 more) All-cause hospitalisation (dichotomous) 408 MODERATEa due to imprecision (from 32 fewer to 159 more) Participants with NYHA class I status 400 VERY LOWa,c,e due to risk of bias, indirectness, imprecision (from 40 fewer to 39 more) Hyperkalaemia serum potassium > or 5.5mm/L MODERATEc due to risk of bias (from 59 more to 119 more) Worsening renal function variousd MODERATEc due to risk of bias (from 39 more to 120 more) Gynaecomastia variousf LOWc,e due to risk of bias, indirectness Peto Odds (from 8 more to 32 more) (a) Downgraded by 1 increment if the confidence interval crossed one MID or by 2 increments if the confidence interval crossed both MIDs. Treating Heart Failure Chronic Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: (b) Unable to calculate as the control group risk was not reported. 