currently treated with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker or aldosterone antagonist, aliskiren, or angiotensin receptor-neprilysin inhibitors (arni) serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.73m2 or no egfr testing within the last 3 months, or for those intended for management at home (australia only), an egfr <45ml/min/1.73m2 or no egfr testing within the last 3 months known symptomatic postural hypotension known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below intolerance of arb pregnancy or risk of pregnancy, defined as; (in australia only) women younger than 51 years who have not had a negative pregnancy test during the past 3 days and/or who do not agree to use adequate contraception (in india only) women who are pregnant women who are currently breastfeeding individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation

currently treated with an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker or aldosterone antagonist, aliskiren, or angiotensin receptor-neprilysin inhibitors (arni) serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.73m2 or no egfr testing within the last 3 months, or for those intended for management at home (australia only), an egfr <45ml/min/1.73m2 or no egfr testing within the last 3 months known symptomatic postural hypotension known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below intolerance of arb pregnancy or risk of pregnancy, defined as; (in australia only) women younger than 51 years who have not had a negative pregnancy test during the past 3 days and/or who do not agree to use adequate contraception (in india only) women who are pregnant women who are currently breastfeeding individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation

currently treated with an acei, arb or aldosterone antagonist, aliskiren, or angiotensin receptor-neprilysin inhibitors (arni) serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.73m2 or no egfr testing within the last 3 months, or for those intended for management at home (australia only), an egfr <45ml/min/1.73m2 or no egfr testing within the last 3 months known symptomatic postural hypotension known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below intolerance of arb pregnancy or risk of pregnancy, defined as; (in australia only) women younger than 51 years who have not had a negative pregnancy test during the past 3 days and/or who do not agree to use adequate contraception (in india only) women who are pregnant women who are currently breastfeeding individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation

currently treated with an acei, arb or aldosterone antagonist, aliskiren, or angiotensin receptor-neprilysin inhibitors (arni) serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.73m2 or no egfr testing within the last 3 months, or for those intended for management at home (australia only), an egfr <45ml/min/1.73m2 or no egfr testing within the last 3 months known symptomatic postural hypotension known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below intolerance of arb pregnancy or risk of pregnancy, defined as; (in australia only) women younger than 51 years who have not had a negative pregnancy test during the past 3 days and/or who do not agree to use adequate contraception (in india only) women who are pregnant women who are currently breastfeeding individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation

1. currently treated with an acei, arb or aldosterone antagonist, aliskiren, or angiotensin receptor-neprilysin inhibitors (arni) 2. serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months 3. for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.73m2 or no egfr testing within the last 3 months, or for those intended for management at home (australia only), an egfr <45ml/min/1.73m2 or no egfr testing within the last 3 months 4. known symptomatic postural hypotension 5. known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below 6. intolerance of arb 7. pregnancy or risk of pregnancy, defined as; 1. (in australia only) women younger than 51 years who have not had a negative pregnancy test during the past 3 days and/or who do not agree to use adequate contraception 2. (in india only) women who are pregnant 8. women who are currently breastfeeding 9. individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation

1. currently treated with an acei, arb or aldosterone antagonist, aliskiren, or angiotensin receptor-neprilysin inhibitors (arni) 2. serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months 3. for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.73m2 or no egfr testing within the last 3 months, or for those intended for management at home (australia only), an egfr <45ml/min/1.73m2 or no egfr testing within the last 3 months 4. known symptomatic postural hypotension 5. known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below 6. intolerance of arb 7. pregnancy or risk of pregnancy, defined as; 1. (in australia only) women younger than 51 years who have not had a negative pregnancy test during the past 3 days and/or who do not agree to use adequate contraception 2. (in india only) women who are pregnant 8. women who are currently breastfeeding 9. individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation

1. currently treated with an acei, arb or aldosterone antagonist, aliskeren, or angiotensin receptor-neprilysin inhibitors (arni) 2. serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months 3. a) for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.732 or no egfr testing within the last 3 months, or b) for those intended for management at home, an egfr <45ml/min/1.732 or no egfr testing within the last 3 months 4. known symptomatic postural hypotension 5. known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below 6. intolerance of arb 7. women younger than 51 years who have not had a negative pregnancy test during the past 3 days 8. women younger than 51 years who do not agree to use adequate contraception 9. women who are currently breastfeeding 10. individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation

1. currently treated with an acei, arb or aldosterone antagonist, aliskeren, or angiotensin receptor-neprilysin inhibitors (arni) 2. serum potassium > 5.2 mmol/l or no potassium testing within the last 3 months 3. a) for those intended for hospital admission, an estimated glomerular filtration rate (egfr) <30ml/min/1.732 or no egfr testing within the last 3 months, or b) for those intended for management at home, an egfr <45ml/min/1.732 or no egfr testing within the last 3 months 4. known symptomatic postural hypotension 5. known biliary obstruction, known severe hepatic impairment (child-pugh-turcotte score 10-15) - see table below 6. intolerance of arb 7. women younger than 51 years who have not had a negative pregnancy test during the past 3 days 8. women younger than 51 years who do not agree to use adequate contraception 9. women who are currently breastfeeding 10. individuals who are not able to take medications by mouth at enrolment, or who are not expected to be able to take medications by mouth during the first 48 hours after randomisation