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Recognizing and Overcoming Barriers to Optimizing RAAS Inhibitor Use

  • Authors: Javed Butler, MD, MBA, MPH; Mikhail N. Kosiborod, MD; Matthew R. Weir, MD
  • CME Released: 11/23/2021
  • Valid for credit through: 11/23/2022, 11:59 PM EST
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Target Audience and Goal Statement

This activity is intended for cardiologists, nephrologists, and primary care physicians.

The goal of this activity is to discuss the use of renin-angiotensin-aldosterone (RAAS) inhibitors in patients with heart failure (HF) and chronic kidney disease (CKD), the associated risk of hyperkalemia, and how novel potassium binders may help regulate K+ levels to enable the optimal dosing of RAAS inhibitors to improve outcomes in this patient population.

Upon completion of this activity, participants will:

  • Have increased knowledge regarding the
    • Importance of optimal RAAS inhibitor use in patients with CKD and HF
    • Effects of RAAS inhibitors on serum K+ levels
    • Role of potassium binders in enabling RAAS inhibition


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Medscape, LLC encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.



  • Javed Butler, MD, MBA, MPH

    Patrick A. Lehan Chair in Cardiovascular Research
    Professor of Medicine and Physiology
    University of Mississippi
    Jackson, Mississippi


    Disclosure: Javed Butler, MD, MBA, MPH, has the following relevant financial relationships: 
    Advisor or consultant for: Abbott; Adrenomed; American Regent; Amgen; Array; AstraZeneca; Bayer; Boehringer Ingelheim; Bristol Myers Squibb Company; CVRx; G3 Pharmaceutical; Impulse Dynamics; Innolife; Janssen; LivaNova; Medtronic; Merck; Novartis; Novo Nordisk; Relypsa; Roche; Vifor
    Speaker or a member of a speakers bureau for: AstraZeneca; Boehringer Ingelheim; Lilly; Vifor

  • Mikhail N. Kosiborod, MD

    Professor of Medicine
    University of Missouri
    Kansas City School of Medicine
    Saint Luke's Mid America Heart Institute
    Kansas City, Missouri


    Disclosure: Mikhail N. Kosiborod, MD, has the following relevant financial relationships: 
    Advisor or consultant for: Amgen; Applied Therapeutics; AstraZeneca; Bayer; Boehringer Ingelheim; Esperion; Janssen; Lilly; Merck; Novo Nordisk; Sanofi; Vifor
    Grants for clinical research from: AstraZeneca; Boehringer Ingelheim

  • Matthew R. Weir, MD

    Professor and Chief
    Division of Nephrology
    University of Maryland School of Medicine
    Baltimore, Maryland


    Disclosure: Matthew R. Weir, MD, has the following relevant financial relationships: 
    Advisor or consultant for: Akeiba; AstraZeneca; Bayer; Boehringer Ingelheim; Janssen; Merck; Novo Nordisk; Vifor


  • George Boutsalis, PhD

    Director, Content Development, Medscape, LLC


    Disclosure: George Boutsalis, PhD, has disclosed no relevant financial relationships.

  • Fred Stange, DO

    Scientific Content Manager, Medscape, LLC


    Disclosure: Fred Stange, DO, has disclosed no relevant financial relationships.

CME Reviewer

  • Leigh Schmidt, MSN, RN, CMSRN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC


    Disclosure: Leigh Schmidt, MSN, RN, CMSRN, CNE, CHCP, has disclosed no relevant financial relationships.

None of the nonfaculty planners for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed no relevant financial relationships.

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Recognizing and Overcoming Barriers to Optimizing RAAS Inhibitor Use

Authors: Javed Butler, MD, MBA, MPH; Mikhail N. Kosiborod, MD; Matthew R. Weir, MDFaculty and Disclosures

CME Released: 11/23/2021

Valid for credit through: 11/23/2022, 11:59 PM EST


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What are the benefits of using RAAS inhibitors in patients with HF and CKD? What are the barriers preventing the optimal use of RAAS inhibitors? How can you overcome and manage elevated K+ levels resulting from RAAS inhibitor use? This Medscape micro activity consists of brief video-based chapters where our expert faculty provide you with the information you seek on these questions. Please choose the chapters you are interested to learn more about, in any order, and build up your CME credits with the  Medscape micro calculator.  

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