RT Journal Article
SR Electronic
T1 Hypokalemia during the treatment of arterial hypertension with diuretics
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 905
OP 907
VO 122
IS 8
A1 Lemieux, G.
A1 Beauchemin, M.
A1 Vinay, P.
A1 Gougoux, A.
YR 1980
UL http://www.cmaj.ca/content/122/8/905.abstract
AB In a study of 50 patients with uncomplicated arterial hypertension the administration of hydrochlorothiazide, 50 to 100 mg daily or every other day, with or without reserpine, 0.25 mg daily, resulted in a fall in the mean blood pressure from 182/113 to 144/92 mm Hg. The mean duration of therapy was 19 months. The mean serum potassium concentration was 4.3 mmol/l before the onset of therapy. It fell during the first 6 weeks of treatment, but seldom below 3.5 mmol/l, then rose gradually and spontaneously to 4.1 mmol/l after 19 months of therapy. All the patients remained asymptomatic. These findings bring into question the routine use of potassium supplements or a potassium-sparing diuretic, such as spironolactone or triamterene, during the treatment of hypertension with diuretics such as the thiazides. The use of potassium supplements or a potassium-sparing agent may induce hyperkalemia in spite of the simultaneous administration of a diuretic that acts more proximally. Since hyperkalemia is potentially lethal, the serum potassium concentration should be carefully monitored in any patient receiving potassium supplements or a potassium-sparing agent.