In the UK the potassium sparing diuretics are fourth-line for hypertension but I hear chatter that they may move up the list. However with the side-effect profile that spironolactone has some clinicians are nervous about prescribing it. With eplerenone this appears to be less than an issue but is not licensed for hypertension even though it appears to reduce blood pressure a lot anecdotally. I wanted to ask whether you see them having a greater role going forward, and if so, what would the top dose of eplerenone be in this context?
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