Study Of The Relationship Between Hypokalemia And Common Cardiovascular Diseases In The Elderly

Objective: Retrospective analyze of the prevalence of hypokalemia in elderly inpatients in the department of internal medicine in our hospital,and to understand the proportion of hypokalemia,clinical symptoms,electrocardiogram and cardiac color ultrasound among people of different genders and ages.Statistics on the prevalence,medication and therapeutic effect of hypokalemia complicated with hypertension,coronary heart disease,heart failure,arrhythmia,valvular heart disease and other common cardiovascular diseases.To analyze the correlation between hypokalemia and cardiovascular disease,and to explore the pathophysiological mechanism between cardiovascular disease and hypokalemia by consulting the literature at home and abroad.Methods: Retrospective statistics were made on the general clinical data of elderly inpatients diagnosed as "hypokalemia" in the internal medicine ward of our hospital during a period of time.The general clinical data of the patients were collected,including age,sex,current illness,degree of hypokalemia,potassium supplement treatment,clinical manifestations related to hypokalemia and auxiliary examination results,etc.and the data were analyzed by SPSS23.0 software.The measurement data which accorded with normal distribution were analyzed by Pearson correlation analysis,and the counting data were analyzed by chi-square test or Spearman correlation analysis.Results: Among the 425 patients with hypokalemia,the proportion of patients with cardiovascular disease was the highest,about 71.76%.followed by respiratory diseases(36.47%),endocrine system diseases(31.76%),digestive system diseases(30.59%),urinary system diseases(14.35%).Blood system(9.18%)and rheumatic immune diseases(4.47%).According to statistics,the common cardiovascular diseases are hypertension(49.65%),arrhythmia(35.06%),coronary heart disease(23.29%),cardiac insufficiency(13.41%),valvular heart disease(12.47%),heart failure(6.82%),pulmonary heart disease(1.88%),cardiomyopathy(0.94%)and pericardial effusion(0.47%).Through correlation analysis,it was found that when the serum potassium level was lower than the normal range,the increase of cardiovascular disease was negatively correlated with the decrease of serum potassium level(P<0.001).With the increase of age,the number of the type of cardiovascular disease increased(P<0.05).And the number of type of cardiovascular disease was negatively correlated with the decrease of serum potassium level(P < 0.05).Among the patients with hypokalemia,about 25.41% of the patients without hypokalemia symptoms,and 74.59% of the patients have at least one clinical symptom related to hypokalemia.According to the statistics of 425 ECG reports,abnormal ECG account for 63.06%,In the abnormal ECG manifestations,ST segment changes account for 31.76%,followed by T wave flat or inverted(16.47%),QT interval prolonged(17.88%),conduction block(including atrioventricular block and bundle branch block) account for 16.24%,abnormal Q wave(9.65%),Sinus arrhythmias(including sinus tachycardia and sinus bradycardia)account for 7.53%,atrial extrasystole(7.67%),atrial fibrillation or atrial flutter(6.82%),and ventricular extrasystole(4.94%).Except for ST segment change,QT interval prolongation and ventricular extrasystole,there was no significant difference in the distribution of other abnormal ECG among different severity hypokalemia groups(P>0.05).264 reports of cardiac color Doppler ultrasound were collected,including mild hypokalemia group(n=193),moderate hypokalemia group(n=65)and severe hypokalemia group(n = 6).LVEF from14% to 65%,The average of LVEF is 54.56 ±8.123%.In the manifestations of cardiac color ultrasound,the increased heart volume account for 38.64%,followed by ventricular hypertrophy(24.24%),cardiac valvular insufficiency(16.67%),abnormal wall motion(14.77%),decreased diastolic function(1.89%),cardiac valvular stenosis(0.76%),and pulmonary hypertension(0.76%).About 29.18% of the patients used diuretics during hospitalization,including furosemide,torasemide and spironolactone.With the increase of the proportion of diuretics,the severity of hypokalemia gradually increased(P < 0.05).The proportion of diuretics use in patients with cardiovascular disease was significantly higher than that in patients without cardiovascular disease(P<0.001).After potassium supplement treatment,about 64% of the patients’ serum potassium returned to the normal level.Among them,the recovery rate of serum potassium in mild hypokalemia group was 60.13%,77.78% in moderate hypokalemia group and 53.33% in severe hypokalemia group.according to the statistical results,the serum potassium recovery rate of patients with potassium supplement on the same day of low potassium was significantly higher than that of patients with delayed potassium supplement(68.12% vs46.99%).Conclusion: Hypokalemia with cardiovascular disease in elderly patients have a higher proportion in our study,with the increase of age,the number of type of cardiovascular disease shows an increasing trend,while with the increase of the number of type of cardiovascular disease,the level of serum potassium shows a downward trend as a whole.In elderly patients,the incidence of hypokalemia complicated with arrhythmia is higher,nearly 2/3 patients have abnormal ECG performance,we need to pay attention to ECG monitoring in clinical work to facilitate the detection of hypokalemia as soon as possible.The proportion of diuretics use in patients with cardiovascular disease was significantly higher than that in patients with non-cardiovascular diseases,and the level of serum potassium decreased gradually with the increase of the proportion of diuretics,which made the correction of hypokalemia more slowly.More than 2/3 elderly patients with hypokalemia have hypokalemia-related symptoms,we need to pay more attention to the inquiry of medical history in clinical work,so as to facilitate timely detection and active intervention to improve the quality of life of the patients.