{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T07:19:43Z","timestamp":1782371983429,"version":"3.54.5"},"reference-count":61,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,5,23]],"date-time":"2020-05-23T00:00:00Z","timestamp":1590192000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hyperkalemia is a frequent and sometimes life\u2010threatening condition that may be associated with arrhythmia and cardiac dysfunction in patients with heart failure (HF). High potassium levels in HF represent both a direct risk for cardiovascular complication and an indirect biomarker of the severity of the underlying disease, reflecting neurohormonal activation and renal dysfunction. Evaluating the prevalence and significance of hyperkalemia in HF patients is essential for optimizing the use of potassium sparing agents, such the renin\u2013angiotensin\u2013aldosterone system inhibitors (RAASi) or angiotensin receptor\u2010neprilysin inhibitors and mineralocorticoid receptor antagonists, which represent a well\u2010established cornerstone and life\u2010saving therapy. In this review we discuss recent findings and current concepts related to the epidemiology, pathological mechanisms and implications of hyperkalemia, as well as novel therapeutic approaches to counteract it in patients with HF. The balance between optimizing life\u2010saving potassium sparing medication and minimizing hyperkalemia\u2010associated risk is much needed in patients with HF. Although older potassium\u2010binding agents are associated with serious adverse events, novel potassium\u2010binding drugs are effective in lowering potassium levels and are generally well tolerated. Novel potassium\u2010binding drugs, such as patiromer and sodium zirconium cyclosilicate, may help to optimize therapy in HF and achieve guideline\u2010recommended doses. Hyperkalemia is common in HF patients and is associated with a poorer prognosis and an increased risk of cardiovascular complications: Contrariwise, \u201cmoderate\u201d potassium levels go with a better prognosis, while the emergence of new drugs, potassium binders, could allow target doses of RAASi to be achieved.<\/jats:p>","DOI":"10.1002\/clc.23392","type":"journal-article","created":{"date-parts":[[2020,5,23]],"date-time":"2020-05-23T08:38:32Z","timestamp":1590223112000},"page":"666-675","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Hyperkalemia in heart failure: Foe or friend?"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9842-962X","authenticated-orcid":false,"given":"Amina","family":"Rakisheva","sequence":"first","affiliation":[{"name":"Department of Cardiology Scientific Institution of Cardiology and Internal Diseases  Almaty Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-3430","authenticated-orcid":false,"given":"Maria","family":"Marketou","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heraklion University Hospital  Crete Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Klimenko","sequence":"additional","affiliation":[{"name":"RUDN University  Moscow Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatyana","family":"Troyanova\u2010Shchutskaia","sequence":"additional","affiliation":[{"name":"Department of Cardiology Scientific and Practical Center of Cardiology  Minsk Belarus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panos","family":"Vardas","sequence":"additional","affiliation":[{"name":"Department of Cardiology Heart Sector, Hygeia Hospitals Group  Athens 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