1. Impact of Plasma Potassium Normalization on Short-Term Mortality in Patients With Hypertension and Hyperkalemia
- Author
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Christian Torp-Pedersen, Gunnar Gislason, Henrik Bøggild, Maria Lukács Krogager, Kristian Kragholm, and Peter Søgaard
- Subjects
Normalization (statistics) ,Adult ,Male ,medicine.medical_specialty ,hypertension ,Hyperkalemia ,Epidemiology ,potassium normalization ,Denmark ,Short term mortality ,030204 cardiovascular system & hematology ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Potassium/adverse effects ,Antihypertensive Agents ,Original Research ,Aged ,Proportional Hazards Models ,hyperkalemia correction ,Aged, 80 and over ,Antihypertensive Agents/therapeutic use ,business.industry ,Middle Aged ,hyperkalemia ,Hypertension/blood ,Survival Analysis ,Denmark/epidemiology ,Death ,Hyperkalemia/complications ,Serum potassium ,Potassium ,Cardiology ,Drug Therapy, Combination ,Female ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Background Hyperkalemia can be harmful, but the effect of correcting hyperkalemia is sparsely studied. We used nationwide data to examine hyperkalemia follow‐up in patients with hypertension. Methods and Results We identified 7620 patients with hypertension, who had the first plasma potassium measurement ≥4.7 mmol/L (hyperkalemia) within 100 days of combination antihypertensive therapy initiation. A second potassium was measured 6 to 100 days after the episode of hyperkalemia. All‐cause mortality within 90 days of the second potassium measurement was assessed using Cox regression. Mortality was examined for 8 predefined potassium intervals derived from the second measurement: 2.2 to 2.9 mmol/L (n=37), 3.0 to 3.4 mmol/L (n=184), 3.5 to 3.7 mmol/L (n=325), 3.8 to 4.0 mmol/L (n=791), 4.1 to 4.6 mmol/L (n=3533, reference), 4.7 to 5.0 mmol/L (n=1786), 5.1 to 5.5 mmol/L (n=720), and 5.6 to 7.8 mmol/L (n=244). Ninety‐day mortality in the 8 strata was 37.8%, 21.2%, 14.5%, 9.6%, 6.3%, 6.2%, 10.0%, and 16.4%, respectively. The multivariable analysis showed that patients with concentrations >5.5 mmol/L after an episode of hyperkalemia had increased mortality risk compared with the reference (hazard ratio [HR], 2.27; 95% CI, 1.60–3.20; P P P 5.0 mmol/L were associated with increased risk of cardiovascular death. Conclusions Overcorrection of hyperkalemia to levels 5.5 mmol/L were also associated with an increased all‐cause and cardiovascular mortality.
- Published
- 2020
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