Prevalence and associated factors of hypokalemia in hypertension: the perspective in a low to middle-income setting

Background: Despite being a common feature that can be present either as a complication of treatment or a sign of primary aldosteronism, the true prevalence of hypokalemia has not been enough documented in a low to middle-income setting. This study sought to determine the prevalence and associated factors of hypokalemia at the outpatient department of the Douala General Hospital (DGH), Cameroon. Methods: Records obtained from the hypertension registry of the DGH were reviewed and those with confirmed white coat hypertension were excluded from the study. Univariate and multivariate logistic regression was used to determine factors associated with hypokalemia in hypertension. Results: A total of 687 records (62.1% females, mean age 57.5±12.9 years) were included in the study. One hundred and eighty (26.2%) records had hypokalemia. Participants on diuretics were more likely to develop hypokalemia, and those receiving indapamide or chlorthalidone (OR =5.7, P<0.001 and OR =4.8, P=0.02 respectively) were more likely to have hypokalemia than those on hydrochlorothiazide (OR =1.9, P=0.01). Conclusions: Hypokalemia was very frequent amongst our patients with hypertension but not systematically well investigated. Diuretics prescription was the main associated factor. These findings have implications for the investigation and management of individuals with hypertension in our setting.