Potassium restoration in hypertensive patients made hypokalemic by hydrochlorothiazide.
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.
Schnaper
H W
HW
Center for Aging, University of Alabama, Birmingham 35294.
Freis
E D
ED
Friedman
R G
RG
Garland
W T
WT
Hall
W D
WD
Hollifield
J
J
Jain
A K
AK
Jenkins
P
P
Marks
A
A
McMahon
F G
FG
D000328:Adult; D000368:Aged; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects* / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy*; D007008:Hypokalemia / Q000097:blood / Q000139:chemically induced*; D008274:Magnesium / Q000097:blood; D008875:Middle Aged; D010349:Patient Compliance; D011188:Potassium / Q000097:blood*; D011897:Random Allocation
D006852:Hydrochlorothiazide; D008274:Magnesium; D011188:Potassium