Abstract
To the Editor.— Most hypertensive patients treated vigorously with diuretics manifest variable lowering of serum potassium (K + ) levels and, often, nonspecific ECG abnormalities. Low serum K + levels increase myocardial irritability and the risk of cardiac arrhythmias and sudden death. Prevention of hypokalemia causes less risk than detection and later correction. Many cardiologists routinely administer supplemental K + or K + -sparing agents concurrent with diuretics in patients with normal renal function. Evidence also suggests that a high K + intake increases the effectiveness of antihypertensive therapy. The high mortality in hypertensive men receiving diuretic therapy with resting ECG abnormalities in the MRFIT was most probably related to low serum K + levels. If contrary information is available, it should be promptly reported. It seems unlikely that unfavorable results were caused by drug toxicity.
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