Racial differences in patients' potassium concentrations during spironolactone therapy for heart failure

Larisa H. Cavallari, Lucy A. Fashingbauer, Amber L. Beitelshees, Vicki L. Groo, Mary R. Southworth, Marlos A.G. Viana, Randall E. Williams, Stephanie Dunlap

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Study Objective. To determine whether the effects of spironolactone on potassium homeostasis vary by race by comparing serum potassium concentrations and potassium supplement use in African-American and Caucasian patients receiving spironolactone for heart failure. Design. Retrospective medical record review. Setting. Two heart failure centers. Patients. Fifty African-American and 67 Caucasian patients with heart failure who were receiving a stable dosage of spironolactone in addition to standard heart failure therapy with an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker. Measurements and Main Results. Medical records of eligible patients were reviewed by pharmacists and physicians who specialize in heart failure management. No significant differences were observed in diuretic therapy or renal function between racial groups; however, African-Americans were receiving higher doses of ACE inhibitors. African-Americans had lower serum potassium concentrations (4.2 ± 0.4 vs 4.5 ± 0.5 mEq/L, p<0.01) and a higher prevalence of potassium supplementation (48% vs 15%, p<0.01). In a subset of patients, spironolactone therapy was associated with a 2-fold greater increase in serum potassium concentration and a 3-fold greater reduction in potassium supplement use among Caucasians than African-Americans. Conclusion. Our findings suggest that a large percentage of patients with heart failure, particularly African-Americans, still require potassium supplementation despite treatment with spironolactone and standard vasodilator therapy.

Original languageEnglish (US)
Pages (from-to)750-756
Number of pages7
JournalPharmacotherapy
Volume24
Issue number6
DOIs
StatePublished - Jun 1 2004
Externally publishedYes

Fingerprint

Spironolactone
Potassium
Heart Failure
African Americans
Therapeutics
Angiotensin-Converting Enzyme Inhibitors
Medical Records
Serum
Angiotensin Receptor Antagonists
Vasodilator Agents
Pharmacists
Diuretics
Homeostasis
Physicians
Kidney

Keywords

  • Angiotensin receptor blocker
  • Angiotensin-converting enzyme inhibitor
  • Heart failure
  • Potassium supplementation
  • Racial differences
  • Serum potassium concentration
  • Spironolactone

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Cavallari, L. H., Fashingbauer, L. A., Beitelshees, A. L., Groo, V. L., Southworth, M. R., Viana, M. A. G., ... Dunlap, S. (2004). Racial differences in patients' potassium concentrations during spironolactone therapy for heart failure. Pharmacotherapy, 24(6), 750-756. https://doi.org/10.1592/phco.24.8.750.36076

Racial differences in patients' potassium concentrations during spironolactone therapy for heart failure. / Cavallari, Larisa H.; Fashingbauer, Lucy A.; Beitelshees, Amber L.; Groo, Vicki L.; Southworth, Mary R.; Viana, Marlos A.G.; Williams, Randall E.; Dunlap, Stephanie.

In: Pharmacotherapy, Vol. 24, No. 6, 01.06.2004, p. 750-756.

Research output: Contribution to journalReview article

Cavallari, LH, Fashingbauer, LA, Beitelshees, AL, Groo, VL, Southworth, MR, Viana, MAG, Williams, RE & Dunlap, S 2004, 'Racial differences in patients' potassium concentrations during spironolactone therapy for heart failure', Pharmacotherapy, vol. 24, no. 6, pp. 750-756. https://doi.org/10.1592/phco.24.8.750.36076
Cavallari LH, Fashingbauer LA, Beitelshees AL, Groo VL, Southworth MR, Viana MAG et al. Racial differences in patients' potassium concentrations during spironolactone therapy for heart failure. Pharmacotherapy. 2004 Jun 1;24(6):750-756. https://doi.org/10.1592/phco.24.8.750.36076
Cavallari, Larisa H. ; Fashingbauer, Lucy A. ; Beitelshees, Amber L. ; Groo, Vicki L. ; Southworth, Mary R. ; Viana, Marlos A.G. ; Williams, Randall E. ; Dunlap, Stephanie. / Racial differences in patients' potassium concentrations during spironolactone therapy for heart failure. In: Pharmacotherapy. 2004 ; Vol. 24, No. 6. pp. 750-756.
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AB - Study Objective. To determine whether the effects of spironolactone on potassium homeostasis vary by race by comparing serum potassium concentrations and potassium supplement use in African-American and Caucasian patients receiving spironolactone for heart failure. Design. Retrospective medical record review. Setting. Two heart failure centers. Patients. Fifty African-American and 67 Caucasian patients with heart failure who were receiving a stable dosage of spironolactone in addition to standard heart failure therapy with an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker. Measurements and Main Results. Medical records of eligible patients were reviewed by pharmacists and physicians who specialize in heart failure management. No significant differences were observed in diuretic therapy or renal function between racial groups; however, African-Americans were receiving higher doses of ACE inhibitors. African-Americans had lower serum potassium concentrations (4.2 ± 0.4 vs 4.5 ± 0.5 mEq/L, p<0.01) and a higher prevalence of potassium supplementation (48% vs 15%, p<0.01). In a subset of patients, spironolactone therapy was associated with a 2-fold greater increase in serum potassium concentration and a 3-fold greater reduction in potassium supplement use among Caucasians than African-Americans. Conclusion. Our findings suggest that a large percentage of patients with heart failure, particularly African-Americans, still require potassium supplementation despite treatment with spironolactone and standard vasodilator therapy.

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