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(Hypertension. 2001;38:709.)
© 2001 American Heart Association, Inc.

Obesity- and Diabetes-Related Hypertension

Relation of Cellular Potassium to Other Mineral Ions in Hypertension and Diabetes

Lawrence M. Resnick; Mario Barbagallo; Ligia J. Dominguez; Joseph M. Veniero; J. P. Nicholson; Raj K. Gupta

From the Hypertension Center, New York Presbyterian Hospital-Cornell Medical Center (L.M.R., M.B., J.P.N.), New York, New York; Institute of Internal Medicine and Geriatrics, University of Palermo (M.B., L.J.D.), Palermo, Italy; and Department of Physiology and Biophisics, Albert Einstein College of Medicine (J.M.V., R.K.G.), Bronx, New York.

Correspondence to Lawrence M. Resnick, MD, Hypertension Center, New York Presbyterian Hospital-Cornell Medical Center, 525 E 68th St, Starr 4 Pavillon, New York, NY 10021.

Abstract

Abstract—— To investigate the role of intracellular potassium (K_i)and other ions in hypertension and diabetes, we utilized ³⁹K-, ²³Na-, ³¹P-, and ¹⁹F-nuclear magnetic resonance (NMR) spectroscopy to measure K_i, intracellular sodium (Na_i), intracellular free magnesium (Mg_i), and cytosolic free calcium (Ca_i), respectively, in red blood cells of fasting normotensive nondiabetic control subjects (n=10), untreated (n=13) and treated (n=14) essential hypertensive subjects, and diabetic subjects (n=5). In 12 subjects (6 hypertensive and 6 normotensive controls), ions were also measured before and after the acute infusion of 1 L of normal saline. Compared with those in controls (K_i=148±2.0 mmol/L), K_i levels were significantly lower in hypertensive (132.2±2.9 mmol/L, sig=0.05) and in type 2 diabetic subjects (121.2±6.8 mmol/L, sig=0.05). K_i was higher in treated hypertensives than in untreated hypertensives (139±3.1 mmol/L, sig=0.05) but was still lower than in normals. Although no significant relation was observed between basal K_i and Na_i values, saline infusion elevated Na_i (P<0.01) and reciprocally suppressed K_i levels (142±2.4 to 131±2.2 mmol/L, P<0.01). K_i was strongly and inversely related to Ca_i (r=-0.846, P<0.001), and was directly related to Mg_i (r=0.664, P<0.001). We conclude that (1) K_i depletion is a common feature of essential hypertension and type 2 diabetes, (2) treatment of hypertension at least partially restores K_i levels toward normal, and (3) fasting steady-state K_i levels are closely linked to Ca_i and Mg_i homeostasis. Altogether, these results emphasize the similar and coordinate nature of ionic defects in diabetes and hypertension and suggest that their interpretation requires an understanding of their interaction.

Key Words: potassium • diabetes • calcium • magnetic resonance spectroscopy • hypertension

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