Modification of Potassium-Mortality Relationship by Ethnicity and Race: Solving the Puzzle

blacks. Conversely, compared to whites, the odds of hypokalemia were 63% higher in blacks and 11% lower in Hispanics. Hyperkalemia was associated with increased all-cause mortality in blacks and whites but not in Hispanics. In contrast, hypokalemia was associated with increased all-cause mortality in Hispanics but not among blacks or whites. Despite a large number of cardiovascular events, there was no modification by race and ethnicity of the association of serum K patterns and cardiovascular mortality. From a physiological perspective, these findings are complex and puzzling. Specifically, if these relationships are causally related, one has to wonder what the causes might be. These causes could be related to 2 factors: diet or the distribution of K within and outside the cell. We will attempt to unravel the puzzle by discussing each of these 2 mechanisms.