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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: Rosano, Giuseppe MC, Spoletini, Ilaria, Vitale, Cristiana, Agewall, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Radcliffe Cardiology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848927/
https://www.ncbi.nlm.nih.gov/pubmed/31768268
http://dx.doi.org/10.15420/cfr.2019.8.2
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author Rosano, Giuseppe MC
Spoletini, Ilaria
Vitale, Cristiana
Agewall, Stefan
author_facet Rosano, Giuseppe MC
Spoletini, Ilaria
Vitale, Cristiana
Agewall, Stefan
author_sort Rosano, Giuseppe MC
collection PubMed
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.
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spelling pubmed-68489272019-11-25 Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction Rosano, Giuseppe MC Spoletini, Ilaria Vitale, Cristiana Agewall, Stefan Card Fail Rev Clinical Practice 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. Radcliffe Cardiology 2019-11-04 /pmc/articles/PMC6848927/ /pubmed/31768268 http://dx.doi.org/10.15420/cfr.2019.8.2 Text en Copyright © 2019, Radcliffe Cardiology https://creativecommons.org/licenses/by-nc/4.0/legalcode This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.
spellingShingle Clinical Practice
Rosano, Giuseppe MC
Spoletini, Ilaria
Vitale, Cristiana
Agewall, Stefan
Hyperkalemia and Renin–Angiotensin–Aldosterone System Inhibitors Dose Therapy in Heart Failure With Reduced Ejection Fraction
title 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_short 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
topic Clinical Practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848927/
https://www.ncbi.nlm.nih.gov/pubmed/31768268
http://dx.doi.org/10.15420/cfr.2019.8.2
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