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The propensity of diuretics to cause hypokalemia has led some experts to question the wisdom of using diuretics as first-line agents for hypertension. Schnaper et al. compared three regimens for reversing diuretic-induced hypokalemia.
Of 447 hypertensive patients receiving 50 mg/d of hydrochlorothiazide (HCTZ), 252 developed serum potassium levels between 3.0 and 3.5 mmol/L within one month of therapy. These patients were randomized to receive either 20 mmol of potassium, 40 mmol of potassium, or 75 mg of triamterene daily along with HCTZ.
After four weeks, the mean serum potassium level in the groups receiving high-dose potassium (3.75 mmol/L) or triamterene (3.73 mmol/L) significantly exceeded that of the low-dose potassium group (3.62 mmol…