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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Radcliffe Cardiology
2019
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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. |
format | Online Article Text |
id | pubmed-6848927 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Radcliffe Cardiology |
record_format | MEDLINE/PubMed |
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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