This analysis of SOLVD revealed a significantly lower risk for hospitalization and/or death from HF, death from cardiovascular disease, and death from all causes when a potassium-sparing diuretic was used alone or in combination with a non–potassium-sparing diuretic (5). Of the 6,797 patients, 3,915 were on no diuretic, 68 were on a potassium-sparing diuretic alone, and 338 were on both a potassium-sparing and non–potassium-sparing diuretic. Because of the difficulty in analyzing such a small population of patients with potassium-sparing diuretic alone, the authors' main analysis combines the group of patients using potassium-sparing diuretics alone with the group using both types. Although combining these two groups may be fraught with error, the main purpose of the study was to analyze the effects of potassium-sparing diuretic (presumably spironolactone) regardless of other therapies. In the end, when a multivariable analysis adjusting for other clinical factors and medication use is performed, potassium-sparing diuretics appear to win. Their use was associated with a significant benefit, with a risk of approximately 0.75 for cardiovascular events (hospitalization for HF, death from cardiovascular disease, all-cause death, combined) compared with patients using non–potassium-sparing diuretics alone. Not surprisingly, if no diuretic was required the event rates were significantly lower. In an earlier analysis of SOLVD, no diuretic use was associated with a lower risk for arrhythmic death, compared with any diuretic use, while adjusting for other factors (8). Although the use of any diuretic compared with no diuretic was not evaluated in a multivariable model, it appears those patients not requiring any diuretic have the best health. This appears to be the case in other studies as well (9).