Summary: Heart failure is a disease of civilization importance. About 64.3 million people worldwide suffer from heart failure. This disease significantly increases mortality (5-year survival in pa-tients with heart failure is 45%). Comprehensive treatment of patients with heart failure should form the basis of therapeutic management. The renin-angiotensin-aldosterone system plays an important role in the progression of heart failure and the increase in mortality in these patients. Aldosterone has been shown to have a direct detrimental effect on the function of the heart muscle. Modification of the excitation of the renin-angiotensin-aldosterone system is the primary treatment of heart failure. Aldosterone antagonists are particularly preferred drugs in view of the "aldosterone escape" phenomenon in the treatment of heart failure. Currently used aldosterone antagonists in heart failure are spironolactone and eplerenone. These drugs are effective and prolong the life of patients. Eplerenone has a better safety profile than the older spironolactone. Nevertheless, these drugs have side effects such as hyperkalaemia. In July 2021, a new non-steroidal aldosterone antagonist, finerenon, was approved for use in the United States. This drug has a similar or even better efficacy in the treatment of heart failure, as well as a much better safety profile.