Question
I have high blood pressure and take several medications for it, including a diuretic and an ACE inhibitor. Even though I take potassium supplements, my doctor says my potassium level is too low. What causes this?
Answer
Many diuretics decrease potassium in the blood. Diuretics lower blood pressure by helping your body eliminate sodium and water. This reduces blood volume and helps decrease pressure on your artery walls. When your body excretes excessive amounts of water, it also loses extra potassium. This can lead to low potassium levels in your blood (hypokalemia).
There are potassium-sparing diuretics that don't cause this problem. These include:
- Spironolactone (Aldactone)
- Eplerenone (Inspra)
- Triamterene (Dyrenium)
- Amiloride (Midamor)
Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by helping to relax blood vessels. ACE inhibitors usually increase potassium levels in your blood.
If you're taking an ACE inhibitor and getting enough potassium in your diet but still have low potassium, your doctor may recommend further testing to help identify the underlying cause. Rarely, low potassium may be due to overproduction of the hormone aldosterone (hyperaldosteronism), which increases potassium loss by the kidneys.
Treatment of low potassium may include:
- Increasing potassium in your diet
- Use of potassium supplements
- Changing to a potassium-sparing diuretic
Last Updated: 07/26/2005