MONDAY, Nov. 5 (HealthDay News) -- Heart failure patients are at higher risk of hyperkalemia if they are older and male, and the risk of hyperkalemia increases in patients treated with candesartan even though the drug also reduces the risk of death and hospitalization, according to a report published in the Nov. 13 issue of the Journal of the American College of Cardiology.
Akshay S. Desai, M.D., from Brigham and Women's Hospital in Boston, and colleagues examined the incidence of hyperkalemia in 7,599 patients with heart failure randomly assigned to standard heart failure therapy plus either placebo or the renin-angiotensin-aldosterone inhibitor candesartan.
The researchers found that the candesartan group had a significantly higher rate of aggregate hyperkalemia (1.8 to 5.2 percent) and serious hyperkalemia associated with death or hospitalization (1.1 to 1.8 percent). Candesartan reduced the risk of cardiovascular death or heart failure hospitalization by 16 percent. Regardless of treatment, the risk of hyperkalemia was higher in older patients, males, diabetics, those with high creatinine or potassium, and those taking angiotensin-converting enzyme inhibitors or spironolactone.
"The risk of hyperkalemia is increased in symptomatic heart failure patients with advanced age, male gender, baseline hyperkalemia, renal failure, diabetes, or combined renin-angiotensin-aldosterone system blockade," Desai and colleagues conclude. "Although these groups derive incremental clinical benefit from candesartan, careful surveillance of serum potassium and creatinine is particularly important."
The study was funded by AstraZeneca.
Abstract
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