What should a patient understand about salt substitutes while on HF medications?

• A. Salt substitutes contain potassium and may cause hyperkalemia with ACE inhibitors or MRAs; potassium monitoring is recommended.
• B. Salt substitutes are always safe with HF medications.
• C. Salt substitutes do not affect potassium levels.
• D. Salt substitutes are contraindicated in HF.

Answer: (A)

Salt substitutes swap some sodium for potassium. In heart failure, ACE inhibitors or MRAs can raise potassium levels, so using a salt substitute can lead to hyperkalemia. Hyperkalemia can affect heart rhythm and cause symptoms like weakness or palpitations, or more serious arrhythmias. For this reason, patients should understand that salt substitutes may raise potassium and potassium monitoring is recommended. If a salt substitute is used, potassium should be checked regularly, and the clinician may adjust medications or advise avoiding the substitute based on kidney function and overall potassium levels.