Management of Diuretic Induced Hypokalemia in Elderly Hypertensives

Hypokalemia occurs frequently in elderly hypertensives treated with diuretics, where it enhances cardiovascular, cerebrovascular, and renal risk. Literature Review. We review the evidence that hypertensive patients with diuretic-induced hypokalemia are at special risk from increased penetration of aldosterone into the brain, enhanced mineralocorticosteroid receptor and postreceptor signaling, and enhanced activation of the mineralocorticosteroid receptor by cortisol. This leads to unique considerations for the preferred strategy to prevent or treat hypokalemia in this vulnerable group.