title: The relationship of electrocardiographic left ventricular hypertrophy to decreased serum potassium.
abstract: BACKGROUND
  Low serum potassium (K) is associated with increased blood pressure, impaired cardiac function and renal dysfunction. Although lower serum K is associated with cardiac hypertrophy in animal models, the relationship of low serum K to the presence and severity of electrocardiographic left ventricular hypertrophy (LVH) is unclear.
  
  
  METHODS
  Baseline and yearly Cornell product LVH levels were examined in relation to low serum K (serum K ≤ 3.90 mEq/l, the lowest quartile of baseline K levels) in 8586 patients with baseline K levels. Patients were randomized to losartan-vs atenolol-based treatment and additional hydrochlorothiazide (HCTZ) therapy as needed.
  
  
  RESULTS
  After adjusting for age, sex, race, prior antihypertensive treatment, losartan vs atenolol therapy, HCTZ use, baseline diastolic and systolic pressure, body mass index, serum creatinine and urine albumin/creatinine ratio, baseline serum K ≤ 3.90 was associated with significantly higher mean baseline Cornell product LVH (2898 vs 2801 mm•ms, p = 0.001) and a 24% higher risk of Cornell product LVH > 2440 mm•ms at baseline (OR 1.24, 95% CI 1.11-1.38, p < 0.001). After also adjusting for baseline Cornell product and changes in diastolic and systolic pressure between baseline and each year of measurement, in-treatment serum K ≤ 3.90 determined yearly was associated with significantly higher mean Cornell product LVH at years 1-3 and with statistically significant 16-32% increased risks of LVH by Cornell product at years 1-4.
  
  
  CONCLUSIONS
  A low serum K is independently associated with a greater likelihood and severity of Cornell product LVH during antihypertensive therapy.
authors.affiliation: Division of Cardiology, Weill Cornell Medical College, 525 East 68th Street, New York, NY 10065, USA. pokin@med.cornell.edu
authors.forename: Peter M
authors.initials: PM
authors.lastname: Okin
authors.forename: Sverre E
authors.initials: SE
authors.lastname: Kjeldsen
authors.forename: Lars H
authors.initials: LH
authors.lastname: Lindholm
authors.forename: Björn
authors.initials: B
authors.lastname: Dahlöf
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D006973:Hypertension / Q000097:blood* / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D007008:Hypokalemia / Q000097:blood* / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D019808:Losartan / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D014463:Ultrasonography
chemical_list: D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide; D001262:Atenolol; D019808:Losartan