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STATE-OF-THE-ART PAPER

What is the optimal serum potassium level in cardiovascular patients?

^* Department of Clinical Pharmacology, Ninewells Hospital, Dundee, United Kingdom

^* Reprint requests and correspondence: Dr. John E. Macdonald, Department of Clinical Pharmacology, Ninewells Hospital, Dundee, United Kingdom, DD19SY.
macdonald_je{at}hotmail.com

Humans are prone to sodium overload and potassium depletion. This electrolyte imbalance is important in the pathogenesis of cardiovascular disease and sudden cardiac death. Avoiding hypokalemia is beneficial in several cardiovascular disease states including acute myocardial infarction, heart failure, and hypertension. The evidence highlighting the importance of potassium homeostasis in cardiovascular disease and possible mechanisms explaining potassium's benefits are reviewed. Targets for serum potassium concentration are suggested.

Abbreviations and Acronyms   ACE = angiotensin-converting enzyme   AMI = acute myocardial infarction   BP = blood pressure   ECG = electrocardiogram/electrocardiographic/ electrocardiography   HF = heart failure   LVH = left ventricular hypertrophy   MRFIT = Multiple Risk Factor Intervention Trial   NO = nitric oxide   RAAS = renin-angiotensin-aldosterone system   SCD = sudden cardiac death   VF = ventricular fibrillation   VSMC = vascular smooth muscle cell

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