@article{3107240, title = "Expert consensus document on the management of hyperkalaemia in patients with cardiovascular disease treated with renin angiotensin aldosterone system inhibitors: Coordinated by the Working Group on Cardiovascular Pharmacotherapy of the European Society of Cardiology", author = "Rosano, G.M.C. and Tamargo, J. and Kjeldsen, K.P. and Lainscak, M. and Agewall, S. and Anker, S.D. and Ceconi, C. and Coats, A.J.S. and Drexel, H. and Filippatos, G. and Kaski, J.C. and Lund, L. and Niessner, A. and Ponikowski, P. and Savarese, G. and Schmidt, T.A. and Seferovic, P. and Wassmann, S. and Walther, T. and Lewis, B.S.", journal = "EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY", year = "2018", volume = "4", number = "3", pages = "180-188", publisher = "Oxford University Press", doi = "10.1093/ehjcvp/pvy015", keywords = "aldosterone antagonist; angiotensin antagonist; potassium; renin inhibitor; angiotensin receptor antagonist; biological marker; dipeptidyl carboxypeptidase inhibitor; mineralocorticoid antagonist; potassium, cardiovascular disease; cardiovascular mortality; consensus; disease course; drug effect; human; hyperkalemia; long term care; morbidity; patient care; potassium blood level; potassium restriction; practice guideline; priority journal; recurrent disease; Review; risk reduction; blood; cardiology; cardiovascular disease; chemically induced; chronic kidney failure; consensus; drug effect; hyperkalemia; pathophysiology; renin angiotensin aldosterone system; risk factor; standards; treatment outcome, Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Biomarkers; Cardiology; Cardiovascular Diseases; Consensus; Humans; Hyperkalemia; Mineralocorticoid Receptor Antagonists; Potassium; Recurrence; Renal Insufficiency, Chronic; Renin-Angiotensin System; Risk Factors; Treatment Outcome", abstract = "Renin angiotensin aldosterone system inhibitors/antagonists/blockers (RAASi) are a cornerstone in treatment of patients with cardiovascular diseases especially in those with heart failure (HF) due to their proven effect on surrogate and hard endpoints. Renin angiotensin aldosterone system inhibitors are also the basis in treatment of arterial hypertension, and they are furthermore indicated to reduce events and target organ damage in patients with diabetes and chronic kidney disease, where they have specific indication because of the evidence of benefit. Renin angiotensin aldosterone system inhibitor therapy, however, is associated with an increased risk of hyperkalaemia. Patients with chronic kidney disease and HF are at increased risk of hyperkalaemia and 50% of these patients experience two or more yearly recurrences. A substantial proportion of patients receiving RAASi therapy have their therapy down-titrated or more often discontinued even after a single episode of elevated potassium (K\+) level. Since RAASi therapy reduces mortality and morbidity in patients with cardiovascular disease steps should, when hyperkalaemia develops, be considered to lower K\+ level and enable patients to continue their RAASi therapy. The use of such measures are especially important in those patients with the most to gain from RAASi therapy. © 2017 The Author." }