Evaluation of Hypertension with Hypokalemia

Corridor Consult

Antoine C Abcar, MD; Dean A Kujubu, MD

Winter 2009 - Volume 13 Number 1

Vignette

Your colleague asks for your suggestions on the evaluation and treatment of a woman age 70 years with a five-year history of hypertension who has required progressively more medication because of persistent high blood pressure. She is taking five medications, including a diuretic, but still has a blood pressure of 165/95 mm Hg (well above the current standard definition of hypertension of 140/90 mm Hg). He says that the patient is asymptomatic and that her physical examination was normal. The patient’s serum potassium levels have ranged from 3.2 to 3.5 mEq/L for many years despite potassium supplementation, which had been attributed to her diuretic use. Her renal function is normal.