“Blood pressure vs low potassium problem?”
A patient with high blood pressure is taking a medication to keep it under control. This medication is causing a dangerous low level in the patients potassium levels. the patient is already on a no salt high potassium diet. If they stop taking the blood pressure medication their potassium levels go back to normal but they have dangerous high blood pressure. Given potassium supplements increases their potassium slightly but still in dangerous low levels because the blood pressure medications are flushing them out of the patients system before they can do good. When taking only half of the blood pressure medication, blood pressure elevates to a worrying level and the patient has pain and swelling in the hands, feet, and ankles while the potassium levels with the supplements have a slightly better effect. what should be done?
Male | 44 years old
Complaint duration: 4 months
Medications: Amlodipine, Hydrochlorothiazide
Conditions: high blood pressure
3 Answers
Pt should be seen by an endocrinologist for evaluation of possible endocrine hypertension. Overproduction of certain adrenal hormones can be associated with hard to manage blood pressure and potassium problems.
The potassium decreasing from the hydrochlorthiazide is common. There are several different approaches. Adding a potassium sparing diuretic is helpful. Amiloride or triamterene are two options. An aldosterone receptor such as eplerenone is another option. Also adding a converting enzyme inhibitor such as lisinopril can be helpful.
Dear Patient,
The hydrochlorthiazide you are taking can lower potassium. If potassium supplements are not helping, then there are two classes of drugs that decrease blood pressure and block the loss of potassium by blocking Aldosterone secretion and its receptors. There are the ACE InhIbitors and the angioTensin enzyme inhibitors and Angiotensin receptor blockers. They are monitored with blood work to make sure potassium is not elevated. The Amlodipine, while a good blood pressure lowering drug, can cause ankle edema.
Respectfully,
Marvin A. Leder, MDFACP FACE
The hydrochlorthiazide you are taking can lower potassium. If potassium supplements are not helping, then there are two classes of drugs that decrease blood pressure and block the loss of potassium by blocking Aldosterone secretion and its receptors. There are the ACE InhIbitors and the angioTensin enzyme inhibitors and Angiotensin receptor blockers. They are monitored with blood work to make sure potassium is not elevated. The Amlodipine, while a good blood pressure lowering drug, can cause ankle edema.
Respectfully,
Marvin A. Leder, MDFACP FACE
