Clinical Research Directory

Inclusion Criteria: * 1\. \>70 yrs. 2. Regardless of LVEF but EF measured within past 2 years. For HFpEF echo criteria defined by ≥2 of: LV wall thickness ≥ 12 mm; LV mass index (BSA indexed LVH): male \>115 g/m2, female \>95 g/m2; relative wall thickness ≥0.42; E/e' ≥15 in sinus rhythm (or \> 11 in the setting of atrial fibrillation); tricuspid regurgitation velocity \>2.8 m/s; Left atrial volume index \>34 ml/m2. 3\. GFR ≥ 20 mL/min/1,73 m². 4. NYHA II-IV. 5. On optimal treatment as per physician´s judgement including ACE/ARB/ARNI, beta blockers, SGLT2 inhibitor för HFrEF/HFmrEF, and SGLT2 inhibitors in HFpEF 6. Suboptimal treatment with MRA (defined as: no use or ≤ 25 mg daily 7. And one of following: 1. Prior hyperkalemia (S-K\> 5.0 mmol/L or P-K\> 4.8 mmol/L\*) during MRA treatment within last 24 months, and current S-K ≤ 5.0 or P-K ≤ 4.8 mmol/L 2. Current S-K 4.5-5.0 mmol/L or P-K 4.3-4.8 mmol/L, and potential risk of hyperkalemia as indicated by eGFR 30-45 ml/min/1,73 m2 3. Current S-K 5.1-5.9 mmol/L or P-K 4.9-5.7 mmol/L * Corresponding plasma K (P-K) level is 0.2 mmol lower than serum K(S-K). Hyperkalemia is defined as P-K \> 4,8 mmol/L or S-K \>5,0 mmol/L. Exclusion Criteria: