Journal of General Internal Medicine

, Volume 15, Issue 12, pp 885–890

Serum potassium and cardiovascular mortality

  • Jing Fang
  • Shantha Madhavan
  • Hillel Cohen
  • Michael H. Alderman
Review

DOI: 10.1046/j.1525-1497.2000.91021.x

Cite this article as:
Fang, J., Madhavan, S., Cohen, H. et al. J GEN INTERN MED (2000) 15: 885. doi:10.1046/j.1525-1497.2000.91021.x

Abstract

BACKGROUND: The impact of serum potassium on mortality is inadequately defined.

OBJECTIVE: To determine the association of serum potassium with mortality.

METHODS: We analyzed NHANES I Epidemiological Follow-up Study data from 1974–1992. Of 2,992 subjects with baseline serum potassium, 156 were excluded because their vital status was not known. A total of 2,836 subjects with serum potassium within 2.7–5.4 mmol/L were studied. All-cause and cardiovascular mortality were assessed controlling for sociodemographic status, smoking, medical history, and clinical characteristics.

RESULTS: At baseline, mean age was 46.6 years, and mean serum potassium was 4.07 mmol/L. Subjects were stratified into three groups by mean ± 1 standard deviation of serum potassium: low, 2.7–3.7 mmol/L (N= 77); middle, 3.8–4.4 mmol/L (N=1,982); and high, 4.5–5.4 mmol/L (N=377). The cardiovascular mortality rate per 1,000 person-years adjusted for age, gender, and race for the high serum potassium group (8.1) was significantly higher than the middle (5.3) and low (6.5) serum potassium groups. Further analysis, controlling for age, gender, race, smoking status, cholesterol, and history of diabetes, renal disease, and cardiovascular disease, revealed that the increased cardiovascular mortality among subjects with moderately increased serum potassium was most prominent in those reporting use of diuretics (hazard ratio, 2.65; 95% confidence interval [95% CI], 1.20 to 5.85) and those with abnormal renal function (hazard ratio, 1.89; 95% CI, 1.05 to 3.41).

CONCLUSION: In this general population sample with mostly normal serum potassium, higher serum potassium was independently associated with increased cardiovascular mortality.

Key words

serum potassium NHANES I epidemiological follow-up cardiovascular disease mortality renal function diuretics 

Copyright information

© Society of General Internal Medicine 2000

Authors and Affiliations

  • Jing Fang
    • 1
  • Shantha Madhavan
    • 1
  • Hillel Cohen
    • 1
  • Michael H. Alderman
    • 1
  1. 1.Department of Epidemiology and Social MedicineAlbert Einstein College of MedicineBronx

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