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螺内酯与ACEI合用与高钾血症的相关性在加拿大及美国每年约有500万心力衰竭患者,心衰以药物治疗为主。在过去的20年以前主要用利尿药及强心苷治疗心衰,而目前主要用血管紧张素转换酶抑制药(ACEI)、β受体阻滞药及醛甾酮拮抗药治疗。1999年9月进行的醛固酮评价研究(RALES)证明螺内酯治疗能降低严重心衰的发病率及死亡率。但当螺内酯与ACEI合用可导致威胁生命的高钾血症。1994年住院心衰患者螺内酯的处方为34 张／1000患者,在进行RALES后的2001年,螺内酯的处方迅速上升到149张／1000患者。加拿大安大略省1994- 2001年有130余万66岁以上老年心衰患者,用ACEI治疗心衰有560例发生高钾血症,其中73例死亡。研究发现安大略省用ACEI治疗心衰的老年患者,螺内酯的处方也增加。
Spironolactone and ACEI combined with hyperkalemia in Canada and the United States each year about 5 million patients with heart failure, heart failure to drug-based. In the past 20 years ago mainly with diuretics and cardiac glycosides in the treatment of heart failure, but now mainly with angiotensin-converting enzyme inhibitors (ACEI), β-blockers and aldosterone antagonists. The aldosterone evaluation study (RALES) conducted in September 1999 demonstrated that spironolactone treatment reduced the incidence and mortality of severe heart failure. But when spironolactone and ACEI combined can lead to life-threatening hyperkalemia. Spironolactone regimens in patients with HF in 1994 were 34 per 1000 patients. The prescription for spironolactone rose rapidly to 149 per 1000 patients in 2001 after RALES. Ontario, Canada Between 1994 and 2001, there were more than 1.3 million elderly patients over 66 years old with heart failure. In the treatment of heart failure with ACEI, 560 patients had hyperkalemia and 73 of them died of heart failure. The study found that spironolactone prescriptions were also increased in elderly patients treated with ACE inhibitors in Ontario.