Which class of anti-hypertensive agents is associated with the risk of hypokalemia?

Thiazide diuretics are indeed associated with the risk of hypokalemia, which refers to low levels of potassium in the blood. These medications work by promoting the excretion of sodium and water through the kidneys, leading to increased urine output. Along with sodium, potassium is also excreted in larger amounts when thiazide diuretics are used, which can result in decreased potassium levels over time.

This electrolyte imbalance can lead to various symptoms, including muscle weakness, cramping, and fatigue, and in severe cases, it can cause more serious heart rhythm disturbances. Monitoring potassium levels in patients who are prescribed thiazide diuretics is therefore essential to prevent hypokalemia.

In contrast, other classes of anti-hypertensive agents, such as ACE inhibitors and beta-blockers, do not typically promote potassium loss in the same way and can sometimes even cause hyperkalemia (an increase in potassium levels). Calcium channel blockers also do not have a direct effect on potassium levels. Therefore, thiazide diuretics stand out as the class most commonly linked with the risk of hypokalemia.