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The role of potassium in postural hypotension: electrolytes and neurohumoral factors in elderly hypertensive patients using diuretics
Author(s) -
Luutonen Sinikka,
NEUVONEN P.,
RUSKOAHO H.,
RÄIHÄ I.,
RAJALA T.,
ANTILA K.,
SOURANDER L.
Publication year - 1995
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1995.tb01189.x
Subject(s) - medicine , supine position , plasma renin activity , aldosterone , hyperkalemia , vasopressin , endocrinology , atrial natriuretic peptide , essential hypertension , hypokalemia , renin–angiotensin system , blood pressure , cardiology
. Objective . To study the association between postural hypotension and (i) electrolyte levels and (ii) neurohumoral factors in elderly hypertensive patients using diuretics. Design . Cross‐sectional study of patients and controls. Setting . The subjects were gathered from senior citizen clubs or they were referred to the study by general practitioners. The subjects were examined on a geriatric ward in Turku City Hospital. Subjects . Seven subjects with postural hypotension and 13 controls. Measurements . Plasma electrolyte levels and neurohumoral response to head‐up tilt. Results . There were significantly more hypokalemic subjects in the postural hypotension group (5/7) than in the control group (1/13) ( P < 0.01). The plasma potassium level was negatively correlated to plasma aldosterone ( r = –0.57; P < 0.01) and renin activity ( r = –0.69; P < 0.001). Subjects with postural hypotension had higher levels of noradrenaline, both supine ( P < 0.05) and during tilt ( P < 0.05). There were no significant differences in supine or tilt levels of plasma adrenaline, vasopressin, atrial natriuretic peptide, aldosterone and renin activity between the groups. Conclusion . The results suggest that potassium depletion is associated with postural hypotension in elderly hypertensive patients using diuretics. However, it is unclear whether there is a causative link between potassium depletion and postural hypotension or whether they are both caused by some other factor, e.g. volume contraction.