Prognostic Impact of Mild Hypokalemia in Terms of Death and Stroke in the General Population - a Prospective Population Study

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Mattsson, NickUniversity of Copenhagen (författare)

Prognostic Impact of Mild Hypokalemia in Terms of Death and Stroke in the General Population - a Prospective Population Study

Artikel/kapitelEngelska2018

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Elsevier BV,2018

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LIBRIS-ID:oai:lup.lub.lu.se:d8bbd1c0-7fb5-4b2c-bb39-c4a315dba222
https://lup.lub.lu.se/record/d8bbd1c0-7fb5-4b2c-bb39-c4a315dba222URI
https://doi.org/10.1016/j.amjmed.2017.09.026DOI

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Språk:engelska
Sammanfattning på:engelska

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BACKGROUND: Potassium supplementation reduces the risk of cardiovascular mortality and stroke in population studies; however, the prognostic impact of mild hypokalemia in the general population has not been thoroughly investigated. We aimed to investigate associations between mild hypokalemia and endpoints in the general population.METHODS: participants (48-76 year old) from the general population study "Copenhagen City Heart Study" (n=5916) were studied. Participants were divided into groups according to baseline-values of plasma-potassium (potassium); Hypokalemia (<3.7 mmol/L,n=758), normokalemia (3.7-4.5 mmol/L] n=4973, and high-potassium (>4.5 mmol/L,n=185). Hypokalemia was further divided in potassium<3.4 and 3.4-3.6 mmol/L. The primary endpoints were all-cause mortality and non-fatal validated ischemic stroke. Secondary endpoint was AMI. We adjusted for conventional risk factors, diuretics and atrial fibrillation (AF) at baseline.RESULTS: Mean potassium in the hypokalemic group was 3.5 mmol/L (range 2.6-3.6) and was associated (P<0.05) with increased systolic blood pressure, higher CHA2DS2-VASc-score, and increased use of diuretics as compared with normokalemia. Baseline AF was equally frequent across groups. Median follow-up-time was 11.9 years (Q1-Q3: 11.4-12.5 years). Hypokalemia was borderline associated with increased stroke-risk in a multivariable Cox model (including adjustment for competing risk) as compared with normokalemia (HR:1.40;95%CI:1.00-1.98). The subgroup with potassium<3.4 mmol/L had higher stroke- (HR:2.10;95%CI:1.19-3.73) and mortality-risk (HR:1.32;95%CI:1.01-1.74) as compared with normokalemia. Hypokalemia was not associated with AMI and no increased risk of mortality was seen with concomitant AMI and hypokalemia. No associations were seen with high-potassium.CONCLUSIONS: In a general population mild hypokalemia is associated with increased stroke-risk and to a lesser degree increased mortality-risk.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Journal Article

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Nielsen, Olav WendelboeUniversity of Copenhagen (författare)
Johnson, LindaLund University,Lunds universitet,Internmedicin - epidemiologi,Forskargrupper vid Lunds universitet,Internal Medicine - Epidemiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-laj (författare)
Prescott, EvaUniversity of Copenhagen (författare)
Schnohr, PeterCopenhagen University Hospital (författare)
Jensen, Gorm BojeCopenhagen University Hospital (författare)
Køber, LarsCopenhagen University Hospital (författare)
Sajadieh, AhmadCopenhagen University Hospital (författare)
University of CopenhagenInternmedicin - epidemiologi (creator_code:org_t)

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Ingår i:American Journal of Medicine: Elsevier BV131:3, s. 9-3180002-9343

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Av författaren/redakt...: Mattsson, Nick; Nielsen, Olav We ...; Johnson, Linda; Prescott, Eva; Schnohr, Peter; Jensen, Gorm Boj ...; visa fler...; Køber, Lars; Sajadieh, Ahmad; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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Av lärosätet: Lunds universitet

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