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Antihypertensives Test Prep and Practice Pearls; Part 3 – Aldosterone Antagonists and Vasodilators
Aldosterone antagonists, such as spironolactone and eplerenone, are potassium-sparing diuretics that block aldosterone at the mineralocorticoid receptor in the distal nephron. By reducing sodium and water reabsorption while conserving potassium, they play a key role in heart failure, resistant hypertension, and primary hyperaldosteronism. Clinically, they improve mortality in heart failure with reduced ejection fraction, making them much more than just “add-on” diuretics.
From a safety standpoint, the biggest concerns with aldosterone antagonists are hyperkalemia and renal function decline…
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