Risk of developing hyperkalemia in patients with hypertension treated with combination antihypertensive therapy – a retrospective register-based study

2024

Risk of Hyperkalemia in Hypertensive Patients on Combination Therapy

Sample size: 4391 publication 10 minutes Evidence: moderate

Author Information

Author(s): Fatma Luai Mahdi Al-Janabi, Fatme Moussa, Sarah Taleb, Peter Derek Christian Leutscher, Marc Meller Søndergaard, Dorte Melgaard, Peter Søgaard, Christian Torp-Pedersen, Kristian Kragholm, Maria Lukács Krogager

Primary Institution: Faculty of Medicine, Aalborg University, Aalborg, Denmark

Hypothesis

What is the risk of developing hyperkalemia in patients with hypertension treated with different combinations of antihypertensive therapy?

Conclusion

Patients treated with beta blockers, renin-angiotensin system inhibitors, and mineralocorticoid receptor antagonists within 90 days of treatment initiation are at an increased risk of hyperkalemia.

Supporting Evidence

7.1% of patients developed hyperkalemia within 90 days of starting combination therapy.
BB + RASi + MRA was associated with a significantly higher incidence of hyperkalemia.
Patients treated with RASi + thiazides had the lowest incidence of hyperkalemia.
34.3% of patients redeemed potassium supplements during the study.
Patients with hyperkalemia had a higher incidence of comorbidities such as heart failure and ischemic heart disease.

Takeaway

This study found that some combinations of blood pressure medications can make people more likely to have high potassium levels, which can be dangerous.

Methodology

A retrospective, register-based, nested, case-control study using incidence density matching to compare hyperkalemic patients with normokalemic controls.