Factors associated to renin-angiotensin-aldosterone system inhibitors discontinuation or down-titration due to hyperkalaemia in patients with chronic cardiovascular conditions

Abstract Background/Introduction The renin-angiotensin-aldosterone system inhibitors (RAASI) are one of the keystones medical treatment in chronic cardiovascular disorders and have shown improvements clinical outcomes many trials. Hyperkalaemia is a well-defined non-desirable effect RAASI that occasionally forces to interrupt these medications. That enforced discontinuation or down-titration due hyperkalaemia may adverse prognostic consequences. Purpose Describe demographical, pharmacological variables associated higher risk among individuals with conditions. Methods We used data from more than 375,000 55 years age older, included population-based healthcare database public Institute Health between 2015 2017. participants at least relevant condition: heart failure, kidney disease, diabetes mellitus, ischemic disease hypertension. They had be under as January 1st, 2016, evidence episode (serum potassium >5.0 mmol/L) during 2016. Then, were classified two following profiles: versus unchanged up-titrated. For statistical analysis, we logistic regression calculate multivariable-adjusted odds ratios each study variable, comparing group up-titrated controls (reference group). Results In model, was significantly use RAASI, very high comorbidity index, derangements (both hypokalaemia hyperkalaemia), prior hospitalizations emergency visits. Among treatments, Angiotensin receptor blockers (OR 2.518, 95% CI 2.317–2.735) Angiotensin-converting enzyme 2.341, 2.149–2.549) Aldosterone (1.428, 1.285–1.584). Conclusion These results suggest vulnerable populations such those visits hyperkalaemia. A careful exhaustive management should advised patients. Funding Acknowledgement Type funding sources: Private grant(s) and/or Sponsorship. Main source(s): Josep Comin-Colet has received speaker fees Vifor Pharma.