Effects of Eplerenone on Cardiovascular Disease in HIV (MIRACLE HIV Study)

Exclusion Criteria

• •1. Antihypertensive use including, ACE Inhibitor, ARB, MR blockade, diuretic, potassium (K) supplementation; or BP\>140/90 mmHg. Stable use (\>3 months) of beta-blockers or calcium channel blockers (CCB) (except verapamil) is allowed.
• •2. Unstable statin use \<12 months. Stable use (\>12 months) is allowed.
• •3. Use of full dose ritonavir, nelfinavir, clarithromycin, and other strong inhibitors of CYP3A4, as well as CYP3A4 inducers.
• •4. Continuous oral steroid use (equivalent to prednisone \> 5 mg daily) within the last 3 months.
• •5. Uncontrolled diabetes requiring insulin and/or HbA1c \> 7.5%.
• •6. Creatinine (Cr) \> 1.5 mg/dL or estimated GFR\<60 mL/min/1.73m2.
• •7. K \> 5.5 mEq/L.
• •8. Hemoglobin \< 10 g/dL.
• •9. Known liver disease or ALT \>3x ULN.
• •10. History of congestive heart failure, stroke, myocardial infarction, or known coronary artery disease.
• •11. Pregnant, actively seeking pregnancy or breastfeeding.
• •12. Estrogen, progestin derivative, or other sex steroid use within last 3 months. Stable physiologic testosterone replacement (\> 3 months) is acceptable.
• •13. Current bacterial or other infections.
• •14. Active substance abuse.
• •15. Significant radiation exposure over the course of the year prior to randomization (e.g., radiation therapy, PCI, catheter ablation of arrhythmia) within 12 months of randomization.
• •16. Previous reaction or contraindication to iodine-containing contrast media and gadolinium.
• •17. Coronary artery luminal narrowing \>70% on coronary CTA.