Some clinical dilemmas in medication with inhibitors of the renin-angiotensin-aldosterone system in patients with heart failure

Authors

  • Liuba POPESCU Institute of Cardiology
  • Alexandru CARAUSH Institute of Cardiology

DOI:

https://doi.org/10.52692/1857-0011.2024.1-78.19

Keywords:

inhibitors of the renin-angiotensin-aldosterone system, heart failure, hyperkaliemia

Abstract

Use of renin-angiotensin-aldosterone system inhibitors in patients with heart failure and reduced ejection fraction is associated with functional improvement, an increase in perceived quality of life, a reduction in the probability of cardiovascular death, and a decrease in the number of hospitalizations. Some of these drugs are also efficacious in patients with chronic kidney disease and albuminuria as well as in patients with resistant hypertension. Despite their numerous benefits, renin-angiotensin-aldosterone system inhibitors are associated with an increase in incidence of hyperkalemia, especially in patients with concomitant chronic kidney disease. Hyperkalemia is a common electrolyte disorder that is defined as an elevation in plasma concentrations of potassium above 5 mEq/L. It has been related to rehospitalizations, malignant arrhythmias, and an increase in mortality. On the other hand, optimized treatment with renin-angiotensinaldosterone system inhibitors requires progressive dose increases which can in turn entail a greater probability of hyperkalemia.

Author Biographies

Liuba POPESCU, Institute of Cardiology

ssociate Researcher, Doctor of Medical Sciences; Department Of Hypertension

Alexandru CARAUSH, Institute of Cardiology

Professor, Doctor Habilitated in Medical Sciences; Department Of Hypertension

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Published

2024-08-05

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Research Article

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