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This review explores the complex interplay between hyperkalemia and the use of guideline-directed medical therapies (GDMT), such as reninangiotensinaldosterone system inhibitors (RAASi) and steroidal mineralocorticoid receptor antagonists (sMRAs), including spironolactone and eplerenone, which are currently recommended in guidelines for improving outcomes in heart failure with reduced ejection fraction (HFrEF)

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Summary The proposed integrated approach underscores the importance of personalised nutritional strategies guided by patient-specific metabolic, hormonal, and microbiota profiles, and calls for effective multidisciplinary collaboration among nutritionists, endocrinologists, and behavioural health professionals to optimise therapeutic outcomes

To reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction or non-fatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease