Upadhya B, et al. - Researchers assessed if a direct renin inhibitor could improve the exercise intolerance often seen in older patients (70 ± 7 years) with preserved ejection fraction (HFpEF). In this 6-month prospective, randomized, double-blind, placebo-controlled pilot trial, the impact of aliskiren vs placebo on exercise capacity in older patients with chronic well-compensated heart failure with HFpEF and controlled blood pressure was assessed. After being treated for 6 months with aliskiren, patients showed non-significant trends for modest improvements in peak exercise oxygen consumption and ventilatory anaerobic threshold.