Prevalence and incidence of hyperkalemia in the Spanish population with heart failure with reduced ejection fraction: A systematic review and populational relevance

Abstract Background and objectives Hyperkalemia (K + levels ≥5.5 mmol/L) is a severe ion imbalance that occurs in patients who have heart failure (HF) with reduced ejection fraction (HFrEF) and increases the risk of ventricular fibrillation. Given that there are no estimates on the number of patients with this complication, the aim of this study was to estimate the prevalence and incidence of hyperkalemia in patients with HFrEF in Spain. Material and methods Based on a systematic literature search and through a meta-analysis, we calculated an HFrEF prevalence of ≤40% in the European and U.S. population. Based on another systematic literature search, we calculated the prevalence of hyperkalemia in patients with HF and its annual incidence rate. Considering the previous values and the Spanish population pyramid in 2016, we estimated the number of individuals with HFrEF who currently have hyperkalemia and those who develop it each year in Spain. Results Approximately 17,100 (10,000 men and 7100 women) of the 508,000 patients with HFrEF in Spain have hyperkalemia. Furthermore, approximately 14,900 patients with HFrEF (9500 men and 5400 women) develop hyperkalemia each year. Conclusions Approximately 1 of every 30 patients with HFrEF has plasma potassium values >5.5 mmol/L.