Key result
Hyperkalaemia is common in heart failure and is an important cause of discontinuation or failure to uptitrate guideline-recommended dosages of RAAS inhibitors.
Why the study?
Potassium homeostasis disturbances are common and worsen outcomes in heart failure, but the mortality association is not unequivocal, and hyperkalaemia frequently leads to RAAS inhibitor discontinuation or undertitration.
Hyperkalaemia in heart failure is a significant clinical issue that often leads to the underutilization of life-saving RAAS inhibitor therapies.
Disturbances in the potassium homeostasis are common among patients with heart failure (HF) and negatively affect clinical outcome. Patients with HF have a higher prevalence of common risk factors related to hyperkalaemia, including diabetes mellitus, hypertension, and chronic kidney disease. Furthermore, the use of renin-angiotensin-aldosterone system (RAAS) inhibitors, is an important risk factor for developing hyperkalaemia. The association between hyperkalaemia and mortality is not unequivocal, depends on the study type (trial vs. real-world setting) and is often confounded. More importantly, hyperkalaemia is an important cause of discontinuation or failure to uptitrate to guideline recommended dosages of RAAS inhibitors, which in turn may negatively impact clinical outcomes. The goal of this review is to discuss the epidemiology, aetiology, and clinical consequences of potassium disturbances in HF.
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Tromp et al. (2019) conducted a review in Heart failure and hyperkalaemia. Hyperkalaemia was evaluated. Hyperkalaemia is common in heart failure and is an important cause of discontinuation or failure to uptitrate guideline-recommended dosages of RAAS inhibitors.
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