Update on management of hypokalaemia and goals for the lower potassium level in patients with cardiovascular disease: a review in collaboration with the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy

Author:

Krogager Maria Lukács1ORCID,Kragholm Kristian123,Thomassen Jesper Qvist4,Søgaard Peter1,Lewis Basil S56,Wassmann Sven78,Baumgartner Iris9,Ceconi Claudio10,Schmidt Thomas Andersen1112,Kaski Juan Carlos13ORCID,Drexel Heinz141516ORCID,Semb Anne Grete17ORCID,Agewall Stefan1819ORCID,Niessner Alexander20,Savarese Gianluigi21ORCID,Kjeldsen Keld Per2223,Borghi Claudio24ORCID,Tamargo Juan25ORCID,Torp-Pedersen Christian26

Affiliation:

1. Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark

2. Department of Cardiology, Region Hospital North Jutland, Bispensgade 37, 9800, Hjørring, Denmark

3. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Søndre Skovvej 15, 9000, Aalborg, Denmark

4. Department of Clinical Biochemistry, Copenhagen University Hospital (Rigshospitalet), Blegdamsvej 9, 2100, Copenhagen, Denmark

5. Lady Davis Carmel Medical Center, Mikhal St 7, Haifa, Israel

6. The Ruth and Bruce Rappaport School of Medicine, Technion-IIT, Haifa, Israel

7. Cardiology Pasing, Institutstr. 14, 81241 Munich, Germany

8. Department of Cardiology, University of the Saarland, Kirrbergerstr. 100, 66421 Homburg/Saar, Germany

9. Department of Angiology, Bern University Hospital (Inselspital), Hochschulstrasse 4, 3012, Bern, Switzerland

10. Department of Cardiology, Desenzano Del Garda Hospital, Monte Croce, 25015, Desenzano del Garda, Italy

11. Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Nørregade 10, 2100, Copenhagen, Denmark

12. The Emergency Department, North Zealand University Hospital, Dyrhavevej 29, 3400, Hillerød, Denmark

13. Molecular and Clinical Sciences Research Institute, St George’s, University of London, Cranmer Terrace London SW17 0RE, London, UK

14. Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Landeskrankenhaus, Carinagasse 47 A, 6800, Feldkirch, Austria

15. Private University of the Principality of Liechtenstein, Dorfstrasse 24 FL, 9495, Triesen, Liechtenstein

16. Drexel University College of Medicine, 2900 W. Queen Lane Philadelphia, PA 19129, USA

17. Preventive Cardio-Rheuma Clinic, Department of Rheumatology, Diakonhjemmet Hospital, Reidar Kobros Vei 5, 0370, Oslo, Norway

18. Department of Cardiology, Ullevål, Oslo University Hospital, Kirkeveien 166, 0450, Oslo, Norway

19. Institute of Clinical Sciences, Søsterhjemmet, University of Oslo, Kirkeveien 166, 2nd floor, 0450, Oslo, Norway

20. Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria

21. Division of Cardiology, Department of Medicine, Karolinska Instituttet, Nobels väg 5, 171 77, Solna, Stockholm, Sweden

22. Department of Cardiology, Copenhagen University Hospital (Amager-Hvidovre), Kettegård Alle 30, 2650 Hvidovre, Copenhagen, Denmark

23. Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Fredrik Bajers Vej 7C, 9200, Aalborg, Denmark

24. Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33 - 40126, Bologna, Italy

25. Department of Pharmacology, School of Medicine, CIBERCV, University Complutense, Avda. de Séneca, 2 Ciudad Universitaria, 28040 Madrid, Spain

26. Department of Clinical Research, North Zealand University Hospital, Dyrehavevej 48, 3400, Hillerød, Denmark

Abstract

Abstract Hypokalaemia is common in patients with cardiovascular disease. In this review, we emphasize the importance of tight potassium regulation in patients with cardiovascular disease based on findings from observational studies. To enhance the understanding, we also describe the mechanisms of potassium homeostasis maintenance, the most common causes of hypokalaemia and present strategies for monitoring and management of low potassium levels. We propose elevation of potassium in asymptomatic patients with lower normal concentrations and concurrent cardiovascular disease. These proposals are intended to assist clinicians until more evidence is available.

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Cardiology and Cardiovascular Medicine

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