TY - JOUR

T1 - Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with renin angiotensin aldosterone system inhibitors

T2 - Coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology

AU - Rosano, Giuseppe M.C.

AU - Tamargo, Juan

AU - Kjeldsen, Keld P.

AU - Lainscak, Mitja

AU - Agewall, Stefan

AU - Anker, Stefan D.

AU - Ceconi, Claudio

AU - Coats, Andrew J.S.

AU - Drexel, Heinz

AU - Filippatos, Gerasimos

AU - Kaski, Juan Carlos

AU - Lund, Lars

AU - Niessner, Alexander

AU - Ponikowski, Piotr

AU - Savarese, Gianluigi

AU - Schmidt, Thomas A.

AU - Seferovic, Petar

AU - Wassmann, Sven

AU - Walther, Thomas

AU - Lewis, Basil S.

PY - 2018

Y1 - 2018

N2 - Renin angiotensin aldosterone system inhibitors/antagonists/blockers (RAASi) are a cornerstone in treatment of patients with cardiovascular diseases especially in those with heart failure (HF) due to their proven effect on surrogate and hard endpoints. Renin angiotensin aldosterone system inhibitors are also the basis in treatment of arterial hypertension, and they are furthermore indicated to reduce events and target organ damage in patients with diabetes and chronic kidney disease, where they have specific indication because of the evidence of benefit. Renin angiotensin aldosterone system inhibitor therapy, however, is associated with an increased risk of hyperkalaemia. Patients with chronic kidney disease and HF are at increased risk of hyperkalaemia and 50% of these patients experience two or more yearly recurrences. A substantial proportion of patients receiving RAASi therapy have their therapy down-titrated or more often discontinued even after a single episode of elevated potassium (K\+) level. Since RAASi therapy reduces mortality and morbidity in patients with cardiovascular disease steps should, when hyperkalaemia develops, be considered to lower K\+ level and enable patients to continue their RAASi therapy. The use of such measures are especially important in those patients with the most to gain from RAASi therapy.

AB - Renin angiotensin aldosterone system inhibitors/antagonists/blockers (RAASi) are a cornerstone in treatment of patients with cardiovascular diseases especially in those with heart failure (HF) due to their proven effect on surrogate and hard endpoints. Renin angiotensin aldosterone system inhibitors are also the basis in treatment of arterial hypertension, and they are furthermore indicated to reduce events and target organ damage in patients with diabetes and chronic kidney disease, where they have specific indication because of the evidence of benefit. Renin angiotensin aldosterone system inhibitor therapy, however, is associated with an increased risk of hyperkalaemia. Patients with chronic kidney disease and HF are at increased risk of hyperkalaemia and 50% of these patients experience two or more yearly recurrences. A substantial proportion of patients receiving RAASi therapy have their therapy down-titrated or more often discontinued even after a single episode of elevated potassium (K\+) level. Since RAASi therapy reduces mortality and morbidity in patients with cardiovascular disease steps should, when hyperkalaemia develops, be considered to lower K\+ level and enable patients to continue their RAASi therapy. The use of such measures are especially important in those patients with the most to gain from RAASi therapy.

KW - Arterial hypertension

KW - Chronic kidney disease

KW - Heart failure

KW - Hyperkalaemia

KW - Mineralocorticoid • Mineralocorticoid antagonist

KW - Potassium

KW - Renin angiotensin aldosterone inhibitors

U2 - 10.1093/ehjcvp/pvy015

DO - 10.1093/ehjcvp/pvy015

M3 - Review

C2 - 29726985

AN - SCOPUS:85051098195

VL - 4

SP - 180

EP - 188

JO - European Heart Journal - Cardiovascular Pharmacotherapy

JF - European Heart Journal - Cardiovascular Pharmacotherapy

SN - 2055-6837

IS - 3

ER -