Yesterday, we discussed secondary aldosteronism caused by diuretic treatment. This is an extremely common problem. Hydrochlorothiazide is the 11th most prescribed drug in our country. Lisinopril is third and losartan is 9th. Potassium is 34th. So most providers are just giving potassium to correct the low potassium caused by the thiazide. Spironolactone is 63rd. Eplerenone did not even make the list. It is important to address hypertension and heart failure more effectively and we should become comfortable using these medications appropriately.
You are absolutely correct: the combination of an insurmountable ARB (azilsartan, olmesartan, telmisartan) + eplerenone or spironolactone (the new Kerendia = finerenone is actually a bit more ideal) is likely as beneficial as Entresto in the treatment of heart failure and infinitely less expensive. HRS, MD, FACC
You are absolutely correct: the combination of an insurmountable ARB (azilsartan, olmesartan, telmisartan) + eplerenone or spironolactone (the new Kerendia = finerenone is actually a bit more ideal) is likely as beneficial as Entresto in the treatment of heart failure and infinitely less expensive. HRS, MD, FACC