TY - JOUR
T1 - Short-term mortality risk of serum potassium levels in hypertension
T2 - A retrospective analysis of nationwide registry data
AU - Krogager, Maria Lukacs
AU - Torp-Pedersen, Christian
AU - Mortensen, Rikke Nørmark
AU - Køber, Lars
AU - Gislason, Gunnar
AU - Søgaard, Peter
AU - Aasbjerg, Kristian
PY - 2017
Y1 - 2017
N2 - Aims Diuretics and renin-angiotensin-aldosterone system inhibitors are central in the treatment of hypertension, but may cause serum potassium abnormalities.We examined mortality in relation to serum potassium in hypertensive patients. Methods and results From Danish National Registries, we identified 44 799 hypertensive patients, aged 30 years or older, who had a serum potassium measurement within 90 days from diagnosis between 1995 and 2012. All-cause mortality was analysed according to seven predefined potassium levels: ,3.5 (hypokalaemia), 3.5-3.7, 3.8-4.0, 4.1-4.4, 4.5-4.7, 4.8-5.0, and .5.0 mmol/L (hyperkalaemia). Outcome was 90-day mortality, estimated with multivariable Cox proportional hazard model, with the potassium interval of 4.1-4.4 mmol/L as reference. During 90-day follow-up, mortalities in the seven strata were 4.5, 2.7, 1.8, 1.5, 1.7, 2.7, and 3.6%, respectively. Adjusted risk for death was statistically significant for patients with hypokalaemia [hazard ratio (HR): 2.80, 95% confidence interval (95% CI): 2.17-3.62], and hyperkalaemia (HR: 1.70, 95% CI: 1.36-2.13). Notably, normal potassium levels were also associated with increased mortality: K: 3.5- 3.7 mmol/L (HR: 1.70, 95% CI: 1.36-2.13), K: 3.8-4.0 mmol/L (HR: 1.21, 95% CI: 1.00-1.47), and K: 4.8-5.0 mmol/L (HR: 1.48, 95% CI: 1.15-1.92). Thus, mortality in relation to the seven potassium ranges was U-shaped, with the lowest mortality in the interval of 4.1-4.4 mmol/L. Conclusion Potassium levels outside the interval of 4.1-4.7 mmol/L were associated with increased mortality risk in patients with hypertension.
AB - Aims Diuretics and renin-angiotensin-aldosterone system inhibitors are central in the treatment of hypertension, but may cause serum potassium abnormalities.We examined mortality in relation to serum potassium in hypertensive patients. Methods and results From Danish National Registries, we identified 44 799 hypertensive patients, aged 30 years or older, who had a serum potassium measurement within 90 days from diagnosis between 1995 and 2012. All-cause mortality was analysed according to seven predefined potassium levels: ,3.5 (hypokalaemia), 3.5-3.7, 3.8-4.0, 4.1-4.4, 4.5-4.7, 4.8-5.0, and .5.0 mmol/L (hyperkalaemia). Outcome was 90-day mortality, estimated with multivariable Cox proportional hazard model, with the potassium interval of 4.1-4.4 mmol/L as reference. During 90-day follow-up, mortalities in the seven strata were 4.5, 2.7, 1.8, 1.5, 1.7, 2.7, and 3.6%, respectively. Adjusted risk for death was statistically significant for patients with hypokalaemia [hazard ratio (HR): 2.80, 95% confidence interval (95% CI): 2.17-3.62], and hyperkalaemia (HR: 1.70, 95% CI: 1.36-2.13). Notably, normal potassium levels were also associated with increased mortality: K: 3.5- 3.7 mmol/L (HR: 1.70, 95% CI: 1.36-2.13), K: 3.8-4.0 mmol/L (HR: 1.21, 95% CI: 1.00-1.47), and K: 4.8-5.0 mmol/L (HR: 1.48, 95% CI: 1.15-1.92). Thus, mortality in relation to the seven potassium ranges was U-shaped, with the lowest mortality in the interval of 4.1-4.4 mmol/L. Conclusion Potassium levels outside the interval of 4.1-4.7 mmol/L were associated with increased mortality risk in patients with hypertension.
KW - Hypertension
KW - Mortality
KW - Serum potassium
U2 - 10.1093/eurheartj/ehw129
DO - 10.1093/eurheartj/ehw129
M3 - Journal article
C2 - 28158516
AN - SCOPUS:85015908392
SN - 0195-668X
VL - 38
SP - 104
EP - 112
JO - European Heart Journal
JF - European Heart Journal
IS - 2
ER -