The Relation of Serum Potassium Concentration with Cardiovascular Events and Mortality in Community-Living Individuals

Abstract

Serum potassium concentration ≥5.0 mEq/L was associated with all-cause mortality, CVD death, and non-CVD death in community-living individuals; associations were stronger in diuretic users. Whether maintenance of potassium within the normal range may improve clinical outcomes requires future study.

Association of Serum Potassium with All-Cause Mortality in Patients with and without Heart Failure, Chronic Kidney Disease, and/or Diabetes

“…Our results showing a higher mortality risk for mod-severe hypokalemia differ from a recent report, which noted a 13% non-significant increase in death in subjects with potassium values <3.5 mEq/L, without known CVD [14] .…”

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

“…The true cause of death may not be reflected accurately in death certificates, so a lack of association of K with cardiovascular mortality could be a false negative finding. At least some evidence that Taehee et al [3] may have missed the signal comes from a recent study among people not on dialysis and free of cardiovascular disease at baseline [7]. In this cohort, serum K ≥5.0 mEq/L was associated with both cardiovascular death and non-cardiovascular death [7].…”

“…At least some evidence that Taehee et al [3] may have missed the signal comes from a recent study among people not on dialysis and free of cardiovascular disease at baseline [7]. In this cohort, serum K ≥5.0 mEq/L was associated with both cardiovascular death and non-cardiovascular death [7]. However, this study was limited to people with less intense kidney disease and no cardiovascular disease at baseline.…”

The Importance of a “Just Right” Serum Potassium Level

“…The fact that hypokalemia and hyperkalemia each predict increases in mortality has been reported in multiple community studies and in studies of a variety of disease populations including hypertension, CKD, atherosclerosis, and others [3,4,5,6,7,8]. All of this suggests that closer monitoring of serum potassium and more aggressive prevention or correction/repletion of even modest hypo or hyperkalemia may be appropriate.…”