Supplemental Digital Content is available in the text. Little is known about the occurrence of hypokalemia due to combination therapy for hypertension. Using data from Danish administrative registries, we investigated the association between different combinations of antihypertensive therapy and risk of developing hypokalemia. Using incidence density matching, 2 patients without hypokalemia were matched to a patient with hypokalemia (K, <3.5 mmol/L) on age, sex, renal function, and time between index date and date of potassium measurement. Combination therapies were subdivided into 10 groups including β-blockers (BB)+thiazides (BB+thiazides), calcium channel blockers (CCB)+renin angiotensin system inhibitors (RASi)+thiazides (CCB+RASi+Thiazides), calcium channel blockers+thiazides (CCB+thiazides), and β-blockers+renin angiotensin system inhibitors+thiazides (BB+RASi+thiazides). We used conditional logistic regression to estimate the odds of developing hypokalemia for different combinations of antihypertensive drugs within 90 days of combination therapy initiation. We matched 463 patients with hypokalemia to 926 patients with normal potassium concentrations. The multivariable analysis showed 5.82× increased odds of developing hypokalemia if administered CCB+thiazides (95% CI, 3.06–11.08) compared with CCB+RASi. Other combinations significantly associated with increased hypokalemia odds were BB+thiazides (odds ratio, 3.34 [95% CI, 1.67–6.66]), CCB+RASi+thiazides (odds ratio, 3.07 [95% CI, 1.72–5.46]), and BB+RASi+thiazides (odds ratio, 2.78 [95% CI, 1.41–5.47]). Combinations of thiazides with CCB, RASi, or BB were strongly associated with increased hypokalemia risk within 90 days of treatment initiation.

中文翻译：

---

接受联合降压治疗的高血压患者发生低钾血症的风险

补充数字内容在文本中可用。关于高血压联合治疗导致低钾血症的发生知之甚少。使用丹麦行政登记处的数据，我们调查了抗高血压治疗的不同组合与发生低钾血症的风险之间的关联。使用发病密度匹配，将 2 名无低钾血症患者与一名低钾血症患者 (K，<3.5 mmol/L) 进行年龄、性别、肾功能和指标日期与测钾日期之间的时间匹配。联合治疗分为10组，包括β受体阻滞剂（BB）+噻嗪类（BB+噻嗪类）、钙通道阻滞剂（CCB）+肾素血管紧张素系统抑制剂（RASi）+噻嗪类（CCB+RASi+噻嗪类）、钙通道阻滞剂+噻嗪类（CCB+噻嗪类），和β-受体阻滞剂+肾素血管紧张素系统抑制剂+噻嗪类（BB+RASi+噻嗪类）。我们使用条件逻辑回归来估计在联合治疗开始后 90 天内不同抗高血压药物组合发生低钾血症的几率。我们将 463 名低钾血症患者与 926 名钾浓度正常的患者进行了匹配。多变量分析显示，与 CCB+RASi 相比，如果给予 CCB+噻嗪类药物（95% CI，3.06-11.08），发生低钾血症的几率增加了 5.82 倍。与低钾血症几率增加显着相关的其他组合是 BB+噻嗪类药物（优势比，3.34 [95% CI，1.67-6.66]），CCB+RASi+噻嗪类药物（优势比，3.07 [95% CI，1.72-5.46]），以及BB+RASi+噻嗪类药物（优势比，2.78 [95% CI，1.41–5.47]）。噻嗪类与 CCB、RASi、