- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
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Sheldon G. Sheps, M.D.
Sheldon G. Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Hypertension Division in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," he says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and participated in the fourth, fifth and seventh groups, that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals. He has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material and joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure,'' published in 2008.
He was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee, National High Blood Pressure Education Program, and was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
Definition (3)
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Risk factors (2)
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- Alcohol: Does it affect blood pressure?
Symptoms (1)
- Pulse pressure: An indicator of heart health?
Causes (5)
- Caffeine: How does it affect blood pressure?
- Anxiety: A cause of high blood pressure?
- Blood pressure readings: Why higher at home?
- see all in Causes
Complications (1)
- Hypertensive crisis: What are the symptoms?
Treatments and drugs (5)
- Calcium supplements: Do they interfere with blood pressure drugs?
- Blood pressure medications: Can they raise my triglycerides?
- Diuretics: A cause of low potassium?
- see all in Treatments and drugs
Lifestyle and home remedies (9)
- Resperate: Can it help reduce blood pressure?
- Blood pressure medication: Still necessary if I lose weight?
- High blood pressure and cold remedies: Which are safe?
- see all in Lifestyle and home remedies
Alternative medicine (1)
- L-arginine: Does it lower blood pressure?
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Question
Diuretics: A cause of low potassium?
I have high blood pressure and take several medications for it, including a diuretic and an ACE inhibitor. My doctor says my potassium level is too low. Could this be caused by my medications?
Answer
from Sheldon G. Sheps, M.D.
Many diuretics (sometimes called water pills) decrease potassium in the blood. Diuretics lower blood pressure by helping your body eliminate sodium and water, which reduces blood volume and decreases pressure on your artery walls. When your body excretes excessive amounts of water, it also loses potassium. This can lead to low potassium levels in your blood (hypokalemia).
There are potassium-sparing diuretics that don't cause this problem. These include:
- Spironolactone (Aldactone)
- Eplerenone (Inspra)
- Triamterene (Dyrenium)
Angiotensin-converting enzyme (ACE) inhibitors reduce blood pressure by helping to relax blood vessels. ACE inhibitors usually increase potassium levels in your blood.
If you're taking an ACE inhibitor with a diuretic and getting enough potassium in your diet but your potassium level is still low, your doctor may recommend further testing to help identify the underlying cause. Rarely, low potassium may be due to overproduction of the hormone aldosterone (hyperaldosteronism), which increases potassium loss by the kidneys.
Treatment of low potassium may include:
- Increasing potassium in your diet
- Use of potassium supplements
- Changing to a potassium-sparing diuretic
Beta blockers: Do they cause weight gain?
- Rose BN. Diuretic-induced hypokalemia. http://www.uptodate.com/home/index.html. Accessed May 12, 2008.
- Sheps SG, ed. Mayo Clinic 5 Steps to Controlling High Blood Pressure. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2008.
