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J Am Coll Cardiol, 2004; 43:155-161, doi:10.1016/j.jacc.2003.06.021
© 2004 by the American College of Cardiology Foundation
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STATE-OF-THE-ART PAPER

What is the optimal serum potassium level in cardiovascular patients?

John E. Macdonald, MBChB, MRCP*,* and Allan D. Struthers, BSc, MD, FRCP, FESC*

* 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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