J Fang1, S Madhavan, H Cohen, M H Alderman. 1. Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA. fang@aecom.yu.edu
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 = 477); 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.
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 = 477); 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.
Authors: D S Siscovick; T E Raghunathan; B M Psaty; T D Koepsell; K G Wicklund; X Lin; L Cobb; P M Rautaharju; M K Copass; E H Wagner Journal: N Engl J Med Date: 1994-06-30 Impact factor: 91.245
Authors: Jan M Hughes-Austin; Dena E Rifkin; Tomasz Beben; Ronit Katz; Mark J Sarnak; Rajat Deo; Andrew N Hoofnagle; Shunichi Homma; David S Siscovick; Nona Sotoodehnia; Bruce M Psaty; Ian H de Boer; Bryan Kestenbaum; Michael G Shlipak; Joachim H Ix Journal: Clin J Am Soc Nephrol Date: 2017-01-31 Impact factor: 8.237
Authors: Yan Chen; Alex R Chang; Mara A McAdams DeMarco; Lesley A Inker; Kunihiro Matsushita; Shoshana H Ballew; Josef Coresh; Morgan E Grams Journal: Mayo Clin Proc Date: 2016-08-04 Impact factor: 7.616
Authors: Michael H Alderman; Linda B Piller; Charles E Ford; Jeffrey L Probstfield; Suzanne Oparil; William C Cushman; Paula T Einhorn; Stanley S Franklin; Vasilios Papademetriou; Stephen T Ong; John H Eckfeldt; Curt D Furberg; David A Calhoun; Barry R Davis Journal: Hypertension Date: 2012-03-19 Impact factor: 10.190
Authors: Ragnhild S Falk; Trude Eid Robsahm; Jan Erik Paulsen; Tanja Stocks; Isabel Drake; Trond Heir Journal: BMC Public Health Date: 2021-04-13 Impact factor: 3.295
Authors: Seyed Ali Sadjadi; James I McMillan; Navin Jaipaul; Patricia Blakely; Su Su Hline Journal: Ther Clin Risk Manag Date: 2009-07-12 Impact factor: 2.423