Short-term changes of serum potassium concentration induced by physical exercise in patient with arterial hypertension treated with angiotensin-converting enzyme inhibitor alone or in combination with statin.

Intensive physical exercise may facilitate potassium release from skeletal muscles that may result in hyperkalemia. Commonly used drugs including angiotensin converting enzyme inhibitors (ACEI) and statins increase a risk of hyperkalemia. It is not known whether the effect of these drugs on serum potassium during physical exercise is additive. The study compared the effect of physical exercise on the changes of serum potassium in hypertensive patients receiving ACEI alone or in combination with statin. Eighteen patients with arterial hypertension with normal renal function were included in a prospective placebo-controlled cross-over study. The patients underwent 3 exercise tests on a bicycle ergometer with 55 - 60% of maximum oxygen consumption each lasting 30 minutes, i.e. after being treated with ACEI alone for six months, and then in a random order after the administration of ACEI with statin or ACEI with placebo each time for eight weeks separated by 2-week wash-out. Serum potassium was measured with atomic emission flame spectrometry before and after 15 and 30 minutes exercise and after 30-minute recovery. During the exercise serum potassium concentration increased moderately but significantly during all exercise tests. Mean serum potassium during exercise remained within the normal range. There were no differences in the exercise-induced changes of serum potassium during the exercise tests performed after ACEI combined with statin or with placebo. Addition of statin to ACEI does not increase the risk of hyperkalemia in hypertensive patients with preserved renal function during physical exercise with intensity typical for routine daily activities.