Article Text

Understanding the risk of hyperkalaemia in heart failure: role of aldosterone antagonism
  1. Rosana Poggio1,
  2. Hugo O Grancelli2,
  3. Santiago G Miriuka1,3
  1. 1Heart Failure and Heart Transplant Program, Department of Cardiology, FLENI, Buenos Aires, Argentina
  2. 2Department of Cardiology, FLENI, Buenos Aires, Argentina
  3. 3Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
  1. Correspondence to Dr Santiago G Miriuka, FLENI, Montañeses 2325, Buenos Aires C1428AQK, Argentina; smiriuka{at}


The risk of hyperkalaemia in patients with heart failure has increased in the past few years together with the evolution of pharmacological treatment for these patients. This significant change has been associated with the introduction of angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and aldosterone antagonists. High potassium concentrations in heart failure could lead to life threatening events, and therefore should be taken seriously. In this review we summarise the information about potassium homeostasis in heart failure and the current risk of developing potentially serious hyperkalaemia, particularly in association with the use of aldosterone antagonists.

  • Heart failure
  • potassium
  • spironolactone

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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