Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction

Renin–angiotensin–aldosterone system inhibitors (RAASi) are known to improve outcomes in patients who have heart failure with reduced ejection fraction (HFrEF). To reduce mortality in these patients, RAASi should be uptitrated to the maximally tolerated dose. However, RAASi may also cause hyperkalem...

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Autores principales:	Giuseppe MC Rosano, Ilaria Spoletini, Cristiana Vitale, Stefan Agewall
Formato:	article
Lenguaje:	EN
Publicado:	Radcliffe Medical Media 2019
Materias:	Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/c79eef101b394565888d7685ae8638f1
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spelling	oai:doaj.org-article:c79eef101b394565888d7685ae8638f12021-12-04T16:01:53ZHyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction10.15420/cfr.2019.8.22057-75592057-7540https://doaj.org/article/c79eef101b394565888d7685ae8638f12019-11-01T00:00:00Zhttps://www.cfrjournal.com/articles/Hyperkalemia-Renin-Angiotensin-Aldosterone-System-Inhibitors-HFrEFhttps://doaj.org/toc/2057-7540https://doaj.org/toc/2057-7559Renin–angiotensin–aldosterone system inhibitors (RAASi) are known to improve outcomes in patients who have heart failure with reduced ejection fraction (HFrEF). To reduce mortality in these patients, RAASi should be uptitrated to the maximally tolerated dose. However, RAASi may also cause hyperkalemia. As a result of this side-effect, doses of RAASi are reduced, discontinued and seldom reinstated. Thus, the therapeutic target needed in these patients is often not reached because of hyperkalemia. Also, submaximal dosing of RAASi may be a result of symptomatic hypotension, syncope, hypoperfusion, reduced kidney function and other factors. The reduction of RAASi dose leads to adverse outcomes, such as an increased risk of mortality. Management of these side-effects is pivotal to maximise the use of RAASi in HFrEF, particularly in high-risk patients.Giuseppe MC RosanoIlaria SpoletiniCristiana VitaleStefan AgewallRadcliffe Medical MediaarticleDiseases of the circulatory (Cardiovascular) systemRC666-701ENCardiac Failure Review , Vol 5, Iss 3, Pp 130-132 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	Diseases of the circulatory (Cardiovascular) system RC666-701 Giuseppe MC Rosano Ilaria Spoletini Cristiana Vitale Stefan Agewall Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction
description	Renin–angiotensin–aldosterone system inhibitors (RAASi) are known to improve outcomes in patients who have heart failure with reduced ejection fraction (HFrEF). To reduce mortality in these patients, RAASi should be uptitrated to the maximally tolerated dose. However, RAASi may also cause hyperkalemia. As a result of this side-effect, doses of RAASi are reduced, discontinued and seldom reinstated. Thus, the therapeutic target needed in these patients is often not reached because of hyperkalemia. Also, submaximal dosing of RAASi may be a result of symptomatic hypotension, syncope, hypoperfusion, reduced kidney function and other factors. The reduction of RAASi dose leads to adverse outcomes, such as an increased risk of mortality. Management of these side-effects is pivotal to maximise the use of RAASi in HFrEF, particularly in high-risk patients.
format	article
author	Giuseppe MC Rosano Ilaria Spoletini Cristiana Vitale Stefan Agewall
author_facet	Giuseppe MC Rosano Ilaria Spoletini Cristiana Vitale Stefan Agewall
author_sort	Giuseppe MC Rosano
title	Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction
title_short	Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction
title_full	Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction
title_fullStr	Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction
title_full_unstemmed	Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction
title_sort	hyperkalemia and renin–angiotensin–aldosterone system inhibitors dose therapy in heart failure with reduced ejection fraction
publisher	Radcliffe Medical Media
publishDate	2019
url	https://doaj.org/article/c79eef101b394565888d7685ae8638f1
work_keys_str_mv	AT giuseppemcrosano hyperkalemiaandreninangiotensinaldosteronesysteminhibitorsdosetherapyinheartfailurewithreducedejectionfraction AT ilariaspoletini hyperkalemiaandreninangiotensinaldosteronesysteminhibitorsdosetherapyinheartfailurewithreducedejectionfraction AT cristianavitale hyperkalemiaandreninangiotensinaldosteronesysteminhibitorsdosetherapyinheartfailurewithreducedejectionfraction AT stefanagewall hyperkalemiaandreninangiotensinaldosteronesysteminhibitorsdosetherapyinheartfailurewithreducedejectionfraction
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Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction

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