I thank Dr Rosen for his comments that were based on data presented by Kaplan and co-workers.1 Those data suggest that small, but potentially clinically important, further reductions in blood pressure might be achieved by potassium supplementation for hypertensive patients with diuretic-induced hypokalemia. As the authors point out, the patients were largely overweight black women "who acquired overt hypokalemia during long-term diuretic therapy" and who "may... not have been representative of the majority of hypertensives, who do not do so."1
Black hypertensive subjects tend to have a dietary deficiency of potassium2 and there is an inverse correlation between their urinary potassium excretion and blood pressure.3 It appears logical that the arterial pressure of this population subset might be responsive to potassium supplementation. I would have agreed with Dr Rosen if he had suggested that black hypertensive patients who have diuretic-induced hypokalemia and who have not achieved
Materson BJ. Potassium Supplementation in Diuretic-Induced Hypokalemia-Reply. Arch Intern Med. 1986;146(3):603. doi:10.1001/archinte.1986.00360150257037
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