Total body and serum potassium during prolonged thiazide therapy for essential hypertension

Serum-potassium and total body potassium (T.B.K.) were measured serially for 1 year in a group of eighteen patients with mild essential hypertension. The patients were receiving a single daily dose of 10 mg. bendrofluazide without potassium supplements. At 12 months the mean value for serum-potassium (3-86 mmol per litre) was significantly lower than the mean pre-treatment value (4-26 mmol per litre). There was no significant decrease in T.B.K. in the same period. Diastolic blood-pressure fell significantly, and there were no apparent side-effects from the medication. In the group as a whole, a reduction of about 1 mmol per litre in serum-potassium was associated with an average reduction of 10% in T.B.K., but there was a large individual variation. The amount of potassium loss during the period of study did not seem to be clinically significant. It is suggested that routine potassium supplements are not essential in the treatment of uncomplicated essential hypertension with thiazide diuretics.