Nonarrhythmogenicity of diuretic-induced hypokalemia. Its evidence in patients with uncomplicated hypertension

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Abstract
Patients (20) aged 33-69 yr with uncomplicated hypertension, no heart disease and normal stress test results underwent ambulatory ECG monitoring a month after receiving placebo and 2 and 4 wk after hydrochlorothiazide therapy. Serum K level (.+-. SEM) averaged 4.4 .+-. 0.09 meq/l after the placebo trial and 3.4 .+-. 0.07 and 3.0 .+-. 0.06 meq/l after 2 and 4 wk of therapy, respectively. Patients (16) had no arrhythmias. Four patients had 329 .+-. 140 premature ventricular beats (PVB) while receiving placebo and 341 .+-. 203 and 315 .+-. 158 PVB/24 h after 2 and 4 wk of therapy, respectively. Thus, patients with uncomplicated hypertension and no arrhythmias before diuretic therapy did not experience arrhythmias as a result of diuretic-induced hypokalemia of 1 mo. duration. Patients with low-grade ventricular ectopy (VE) before therapy did not progress to higher grades of VE after diuretic treatment for 4 wk.