 - Miscellaneous such as sarcoidosis, compression of pulmonary vessels by adenopathy, tumor 2. Systemic hypertension, defined as a systolic pressure 140 mmHg or a diastolic blood pressure 90 mmHg 3. Patients taking angiotensin converting enzyme ACE inhibitor or angiotensin receptor blockers ARBs 4. Pregnancy 5. Chronic kidney disease serum creatinine 2.5mgdl, proteinuria 500 mgday, hematuria 6. Cirrhosis or portal hypertension 7. Inability to provide informed consent. 8. Allergy to conivaptan or spironolactone. 9. Active malignancy 10. Patients receiving spironolactone 11. Enrollment in other interventional studies. 12. Patients on Highly Active Antiretroviral Therapy HAART 