Understanding the risk of hyperkalaemia in heart failure: Role of aldosterone antagonism

Postgraduate Medical Journal

Volumn 86, Issue 1013, 2010, Pages 136-142

  Poggio, Rosana ^a   Grancelli, Hugo O ^a   Miriuka, Santiago G ^a,b  

^a FLENI   (Argentina)

^b Universidad Nacional de Río Cuarto Consejo Nacional de Investigaciones Científicas y Técnicas   (Argentina)

Author keywords

[No Author keywords available]

Indexed keywords

ALDOSTERONE ANTAGONIST; ANGIOTENSIN RECEPTOR ANTAGONIST; CANDESARTAN; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; EPLERENONE; MAGNESIUM; PLACEBO; POTASSIUM; SODIUM; SPIRONOLACTONE;

ADD ON THERAPY; ALDOSTERONE RELEASE; CARDIOVASCULAR RISK; CAUSE OF DEATH; CLINICAL TRIAL; COMBINATION CHEMOTHERAPY; DISEASE COURSE; DISEASE SEVERITY; DRUG INDUCED DISEASE; DRUG MONITORING; DRUG SAFETY; FOLLOW UP; HEART EJECTION FRACTION; HEART FAILURE; HEART INFARCTION; HOSPITALIZATION; HUMAN; HYPERKALEMIA; INCIDENCE; KIDNEY DISEASE; KIDNEY FUNCTION; LABORATORY TEST; MAGNESIUM BLOOD LEVEL; MAGNESIUM EXCRETION; MORTALITY; PATHOPHYSIOLOGY; POTASSIUM BLOOD LEVEL; POTASSIUM METABOLISM; PRESCRIPTION; RECOMMENDED DRUG DOSE; REVIEW; RISK ASSESSMENT; RISK REDUCTION; SODIUM BLOOD LEVEL; SUDDEN DEAFNESS; TREATMENT INDICATION;

ALDOSTERONE; ALDOSTERONE ANTAGONISTS; DIURETICS; EVIDENCE-BASED MEDICINE; HEART FAILURE; HUMANS; HYPERKALEMIA; SPIRONOLACTONE;

EID: 77949715013     PISSN: 00325473     EISSN: 14690756     Source Type: Journal    
DOI: 10.1136/pgmj.2008.072058     Document Type: Review

References (47)

1. Williams GH. Aldosterone and heart failure: the rest of the story. Heart Fail Rev 2005;10:5-6.
2. Davidson C, McLachlan MS, Burkinshaw L, et al. Effect of long-term diuretic treatment on body-potassium in heart-disease. Lancet 1976;2:1044-7.
3. Anon. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. The SOLVD Investigattors. N Engl J Med 1992;327:685-91.
4. Packer M, Poole-Wilson PA, Armstrong PW, et al. Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group. Circulation 1999;100:2312-18.
5. Pitt B, Segal R, Martinez FA, et al. Randomised trial of losartan versus captopril in patients over 65 with heart failure (Evaluation of Losartan in the Elderly Study, ELITE). Lancet 1997;349:747-52.
6. Schrier RW. Role of diminished renal function in cardiovascular mortality: marker or pathogenetic factor? J Am Coll Cardiol 2006;47:1-8.
7. Williams GH. Aldosterone biosynthesis, regulation, and classical mechanism of action. Heart Fail Rev 2005;10:7-13.
8. Palmer BF. Managing hyperkalemia caused by inhibitors of the renin-angiotensinaldosterone system. N Engl J Med 2004;351:585-92.
9. Weber KT, Villarreal D. Aldosterone and antialdosterone therapy in congestive heart failure. Am J Cardiol 1993;71:3A-11A.
10. Sica DA. Pharmacokinetics and pharmacodynamics of mineralocorticoid blocking agents and their effects on potassium homeostasis. Heart Fail Rev 2005;10:23-9.
11. Leiter L. Combinations of diuretics in the treatment of edema. Am Heart J 1970;80:422-6.
12. Baliga RR, Ranganna P, Pitt B, et al. Spironolactone treatment and clinical outcomes in patients with systolic dysfunction and mild heart failure symptoms: a retrospective analysis. J Card Fail 2006;12:250-6.
13. Juurlink DN, Mamdani MM, Lee DS, et al. Rates of hyperkalemia after publication of the randomized aldactone evaluation study. N Engl J Med 2004;351:543-51.
14. Anon. Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure. The Acute Infarction Ramipril Efficacy (AIRE) Study Investigators. Lancet 1993;342:821-8.
15. Packer M, Califf RM, Konstam MA, et al. Comparison of omapatrilat and enalapril in patients with chronic heart failure: the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE). Circulation 2002;106:920-6.
16. deDenue S, Tardif JC, White M, et al. Quantification of the risk and predictors of hyperkalemia in patients with left ventricular dysfunction: a retrospective analysis of the studies of left ventricular dysfunction (SOLVD) trials. Am Heart J 2008;152:705-12.
17. Delcayre C, Swynghedauw B. Molecular mechanisms of myocardial remodeling. The role of aldosterone. J Mol Cell Cardiol 2002;34:1577-84.
18. Anon. Effectiveness of spironolactone added to an angiotensin-converting enzyme inhibitor and a loop diuretic for severe chronic congestive heart failure (the Randomized Aldactone Evaluation Study [RALES]). Am J Cardiol 1996;78:902-7.
19. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 1999;341:709-17.
20. Ouzounian M, Hassan A, Cox JL, et al. The effect of spironolactone use on heart failure mortality: a population-based study. J Card Fail 2007;13:165-9.
21. Henry M, Wehrlen M, Pelletier B, et al. Spironolactone versus nifedipine in essential hypertension. Am J Cardiol 1990;65:36K-8K.
22. Nishizaka MK, Zaman MA, Calhoun DA. Efficacy of low-dose spironolactone in subjects with resistant hypertension. Am J Hypertens 2003;16(11 Pt 1):925-30.
23. Ouzan J, Perault C, Lincoff AM, et al. The role of spironolactone in the treatment of patients with refractory hypertension. Am J Hypertens 2002;15(4 Pt 1):333-9.
24. Pitt B, Remme W, Zannad F, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003;348:1309-21.
25. Gao X, Peng L, Adhikari CM, et al. Spironolactone reduced arrhythmia and maintained magnesium homeostasis in patients with congestive heart failure. J Card Fail 2007;13:170-7.
26. Dahlstrom U, Karlsson E. Captopril and spironolactone therapy for refractory congestive heart failure. Am J Cardiol 1993;71:29A-33A.
27. Cruz CS, Cruz AA, Marcilio de Souza CA. Hyperkalaemia in congestive heart failure patients using ACE inhibitors and spironolactone. Nephrol Dial Transplant 2003;18:1814-19.
28. Bozkurt B, Agoston I, Knowlton AA. Complications of inappropriate use of spironolactone in heart failure: when an old medicine spirals out of new guidelines. J Am Coll Cardiol 2003;41:211-14.
29. Svensson M, Gustafsson F, Galatius S, et al. How prevalent is hyperkalemia and renal dysfunction during treatment with spironolactone in patients with congestive heart failure? J Card Fail 2004;10:297- 303.
30. Witham MD, Gillespie ND, Struthers AD. Tolerability of spironolactone in patients with chronic heart failure - a cautionary message. Br J Clin Pharmacol 2004;58:554-7.
31. Tamirisa KP, Aaronson KD, Koelling TM. Spironolactone-induced renal insufficiency and hyperkalemia in patients with heart failure. Am Heart J 2004;148:971-8.
32. Ramadan FH, Masoodi N, El Solh AA. Clinical factors associated with hyperkalemia in patients with congestive heart failure. J Clin Pharm Ther 2005;30:233-9.
33. Saito M, Takada M, Hirooka K, et al. Serum concentration of potassium in chronic heart failure patients administered spironolactone plus furosemide and either enalapril maleate, losartan potassium or candesartan cilexetil. J Clin Pharm Ther 2005;30:603-10.
34. Shah KB, Rao K, Sawyer R, et al. The adequacy of laboratory monitoring in patients treated with spironolactone for congestive heart failure. J Am Coll Cardiol 2005;46:845-9.
35. Obialo CI, Ofili EO, Mirza T. Hyperkalemia in congestive heart failure patients aged 63 to 85 years with subclinical renal disease. Am J Cardiol 2002;90:663-5.
36. Vereijken TL, Bellersen L, Groenewoud JM, et al. Risk calculation for hyperkalaemia in heart failure patients. Neth J Med 2007;65:208-11.
37. Ko DT, Juurlink DN, Mamdani MM, et al. Appropriateness of spironolactone prescribing in heart failure patients: a population-based study. J Card Fail 2006;12:205-10.
38. Masoudi FA, Gross CP, Wang Y, et al. Adoption of spironolactone therapy for older patients with heart failure and left ventricular systolic dysfunction in the United States, 1998-2001. Circulation 2005;112:39-47.
39. McMurray JJ, Ostergren J, Swedberg K, et al. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial. Lancet 2003;362:767-71.
40. Desai AS, Swedberg K, McMurray JJV, et al. Incidence and predictors of hyperkalemia in patients with heart failure: An analyis of the CHARM program. J Am Coll Cardiol 2007;50:1959-66.
41. Macdonald JE, Struthers AD. What is the optimal serum potassium level in cardiovascular patients? J Am Coll Cardiol 2004;43:155- 61.
42. Parham WA, Mehdirad AA, Biermann KM, et al. Hyperkalemia revisited. Tex Heart Inst J 2006;33:40-7.
43. Wrenger E, Muller R, Moesenthin M, et al. Interaction of spironolactone with ACE inhibitors or angiotensin receptor blockers: analysis of 44 cases. BMJ 2003;327:147-9.
44. Schepkens H, Vanholder R, Billiouw JM, et al. Life-threatening hyperkalemia during combined therapy with angiotensin- converting enzyme inhibitors and spironolactone: an analysis of 25 cases. Am J Med 2001;110:438-41.
45. Berry C, McMurray JJ. Serious adverse events experienced by patients with chronic heart failure taking spironolactone. Heart 2001;85:E8.
46. Touitou Y, Touitou C, Bogdan A, et al. Circadian and seasonal variations of electrolytes in aging humans. Clin Chim Acta 1989;180:245-54.
47. Tanabe Y, Ito M, Hosaka Y, et al. Exercise-induced rise in arterial potassium in patients with chronic heart failure. Chest 1999;116:88-96.