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December 1989

Potassium Restoration in Hypertensive Patients Made Hypokalemic by Hydrochlorothiazide

Author Affiliations

From the Center for Aging, University of Alabama in Birmingham (Dr Schnaper); Veterans Administration Medical Center, Washington, DC (Dr Freis); San Diego (Calif) Centre for Stress Studies (Dr Friedman); Margo Morgan Research Center, New Orleans, La (Dr Garland); Emory University School of Medicine, Atlanta, Ga (Dr Hall); Hypertension Center of Nashville (Tenn) (Dr Hollifield); Clinical Research Center Inc, New Orleans (Drs Jain and McMahon); Urban Cardiology Research Center, Garwyn Medical Center, Baltimore, Md (Dr Jenkins); Temple University Hospital, Philadelphia, Pa (Dr Marks); Drug Studies Unit, University of California, San Francisco (Drs Sambol and Williams); and University of Missouri School of Medicine, Kansas City (Dr Winer).

Arch Intern Med. 1989;149(12):2677-2681. doi:10.1001/archinte.1989.00390120043009

• Among 447 hypertensive patients, most with a history of diuretic-induced hypokalemia, 252 developed diuretic-induced hypokalemia while receiving hydrochlorothiazide, 50 mg/d. In a randomized study we evaluated the efficacy of three drug regimens in restoring potassium levels while maintaining blood pressure control: hydrochlorothiazide (50 mg/d) plus potassium supplement (20 mmol/d); hydrochlorothiazide (50 mg/d) plus potassium supplement (40 mmol/d); or hydrochlorothiazide (50 mg/d) with triamterene (75 mg/d) in one combination tablet. In all groups, mean serum levels of potassium rose within 1 week and showed no further change thereafter. However, the hydrochlorothiazide/triamterene and hydrochlorothiazide plus 40 mmol of potassium regimens were significantly more effective in restoring serum potassium levels than was the hydrochlorothiazide plus 20 mmol of potassium regimen. A significant increase in magnesium levels was observed only in the group treated with the hydrochlorothiazide/triamterene combination. Each regimen provided continued control of mild to moderate hypertension.

(Arch Intern Med. 1989;149:2677-2681)

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