Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Impact of Plasma Potassium Normalization on Short-Term Mortality in Patients With Hypertension and Hyperkalemia

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Association Between ECG Abnormalities and Fatal Cardiovascular Disease Among Patients With and Without Severe Mental Illness

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Management of Atrial Fibrillation in Older Patients by Morbidity Burden: Insights From Get With The Guidelines-Atrial Fibrillation

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. High-Dose Glucagon Has Hemodynamic Effects Regardless of Cardiac Beta-Adrenoceptor Blockade: A Randomized Clinical Trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Functional Capacity Past Age 40 in Patients With Congenital Ventricular Septal Defects

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Long-Term Results After Drug-Eluting Versus Bare-Metal Stent Implantation in Saphenous Vein Grafts: Randomized Controlled Trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Temporal changes in the incidence of infective endocarditis in Denmark 1997-2017: A nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. 2020 ESC Guidelines for the management of adult congenital heart disease

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Association Between ECG Abnormalities and Fatal Cardiovascular Disease Among Patients With and Without Severe Mental Illness

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Switching from Vitamin K Antagonist to Dabigatran in Atrial Fibrillation: Differences According to Dose

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

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<0.001). Potassium intervals 3.5 to 3.7 mmol/L and 3.8 to 4.0 mmol/L were also associated with increased risk of death (HR, 1.71; 95% CI, 1.23-2.37; P<0.001; HR, 1.36; 95% CI, 1.04-1.76; P<0.001, respectively) compared with the reference group. We observed a trend toward increased risk of death within the interval 5.1 to 5.5 mmol/L (HR, 1.29; 95% CI, 0.98-1.69). Potassium concentrations <4.1 mmol/L and >5.0 mmol/L were associated with increased risk of cardiovascular death. Conclusions Overcorrection of hyperkalemia to levels <4.1 mmol/L was frequent and associated with increased all-cause and cardiovascular mortality. Potassium concentrations >5.5 mmol/L were also associated with an increased all-cause and cardiovascular mortality.

Original languageEnglish
JournalJournal of the American Heart Association
Volume9
Issue number24
Pages (from-to)e017087
ISSN2047-9980
DOIs
Publication statusPublished - 15 Dec 2020

ID: 61560432