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July 1, 1992

Diuretics, Potassium, and Ventricular Arrhythmias

Author Affiliations

Department of Veterans Affairs Washington, DC

JAMA. 1992;268(1):52-53. doi:10.1001/jama.1992.03490010054021

To the Editor.  —It was interesting to read the article by Siegel et al in the February 26 issue of The Journal.1 We have repeatedly shown that diuretic-induced hypokalemia does not in fact cause arrhythmias in patients with uncomplicated mild to moderate hypertension.I was pleased and reassured that their data in a large population confirmed our observations. In the last 9 years, we have performed studies in hypertensive patients with or without left ventricular hypertrophy and in patients2 with mild3 and moderate or severe left ventricular hypertrophy.4 We assessed the effect of exercise5 on ventricular arrhythmias in diuretic-treated patients and the effect of potassium correction in seriously hypokalemic patients.6 These studies included over 130 patients and yet we found no evidence that hypokalemia aggravates ventricular arrhythmias. In that respect we are in agreement with Siegel et al. However, we differ on their finding