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Potassium Magnesium Citrate Is Superior to Potassium Chloride in Reversing Metabolic Side Effects of Chlorthalidone

Wanpen Vongpatanasin1,2, John M Giacona1,3, Danielle Pittman1

  • 1Department of Internal Medicine, Hypertension Section (W.V., J.M.G., D.P., A.M., G.K.), University of Texas Southwestern Medical Center, Dallas.

Hypertension (Dallas, Tex. : 1979)
|October 17, 2023
PubMed

Insights

Potassium magnesium citrate (KMgCit) can prevent thiazide diuretic-induced hyperglycemia, unlike potassium chloride (KCl). This finding may enhance the cardiovascular safety and tolerability of hypertension treatments.

Area of Science:

  • Endocrinology and Metabolism
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Thiazide diuretics (TD) are first-line hypertension treatments, effective in lowering blood pressure and cardiovascular risk.
  • TD use is associated with an increased risk of diabetes, potentially limiting long-term adherence.
  • While potassium depletion was a suspected cause of TD-induced hyperglycemia, magnesium depletion is also triggered, with its role uninvestigated.

Purpose of the Study:

  • To investigate the effect of potassium magnesium citrate (KMgCit) on fasting plasma glucose and liver fat during TD therapy.
  • To compare KMgCit with potassium chloride (KCl) in modulating metabolic side effects of TD.

Main Methods:

  • A double-blinded randomized controlled trial (RCT) was conducted with 60 non-diabetic hypertension patients.
  • Patients received chlorthalidone alone for 3 weeks, followed by randomization to receive either KCl or KMgCit for 16 weeks.
  • The primary endpoint was the change in fasting plasma glucose.

Main Results:

  • Chlorthalidone monotherapy significantly increased fasting plasma glucose and decreased serum potassium and magnesium levels.
  • KMgCit supplementation significantly attenuated the rise in fasting plasma glucose by 7.9 mg/dL compared to KCl.
  • No significant differences in liver fat were observed between the KMgCit and KCl groups.

Conclusions:

  • Potassium magnesium citrate (KMgCit) is more effective than potassium chloride (KCl) in preventing thiazide diuretic-induced hyperglycemia.
  • This improved metabolic profile may enhance the tolerability and cardiovascular safety of TD therapy in hypertensive patients.
Abstract

Keywords:
chlorthalidonehyperglycemiathiazide diuretics

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