Savarese G, et al. - Researchers looked for independent predictors of mineralocorticoid receptor antagonist (MRA) underuse. Using logistic regression analysis, patients with heart failure with reduced ejection fraction (HFrEF; ejection fraction <40%) and New York Heart Association (NYHA) class II–IV and heart failure (HF) duration ≥6 months from the Swedish HF Registry were studied. No decreased use was noted with elevated potassium, however, a decrease in their use was noted with impaired renal function, even in the creatinine clearance 30–59.9 mL/min range where MRAs are not contraindicated. Further possible reasons for MRA underuse are non-specialist care, milder HF, and no use of other HF therapy.