Chin KL, et al. - Given the benefits of mineralocorticoid receptor antagonists (MRAs) in improving cardiac sympathetic nerve activity, reducing heart rate, and attenuating left ventricular remodeling, researchers investigated how these beneficial effects of MRA are influenced by heart rate in heart failure patients with reduced ejection fraction (HFREF). On performing secondary analysis of data from the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure study, they noted that high resting heart rate of ≥ 80 bpm predisposed patients to greater risk of all outcomes in the trial, regardless of treatment allocation. Eplerenone displayed beneficial effects across all categories of heart rate, without any heterogeneity in the responses.