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In this Danish register-based study, we aimed to investigate the risk of developing hyperkalemia in relation to different combinations of antihypertensive therapy. Using incidence density matching, we matched a hyperkalemic patient to five normokalemic patients on eGFR groups, age, sex, and time between study entry and date of potassium measurement. Combination therapies were subdivided into eight groups: beta blockers (BB)\u2009+\u2009calcium channel blockers (CCB), BB\u2009+\u2009renin angiotensin system inhibitors (RASi), BB\u2009+\u2009RASi\u2009+\u2009mineralocorticoid receptor antagonists (MRA), CCB\u2009+\u2009RASi, CCB\u2009+\u2009RASi\u2009+\u2009thiazides, CCB\u2009+\u2009thiazides, RASi\u2009+\u2009thiazides, and other combinations. Multivariable conditional logistic regression was used to estimate the odds of hyperkalemia within 90 days for each of the eight antihypertensive combination therapies. A total of 793 patients with hyperkalemia were matched to 3598 normokalemic patients. In multivariable analysis, odds of developing hyperkalemia when being treated with BB\u2009+\u2009RASi\u2009+\u2009MRA was 1.95 (95% CI, 1.39\u20132.72) compared to RASi\u2009+\u2009thiazides (reference). CCB\u2009+\u2009thiazides (OR, 0.76 [95% CI, 0.45\u20131.28]) and CCB\u2009+\u2009RASi\u2009+\u2009Thiazid (OR 0.81 [95% CI, 0.51\u20131.28]) were among the others not significantly associated with hyperkalemia. Combinations of BB\u2009+\u2009RASi\u2009+\u2009MRA were significantly associated with an increased risk of developing hyperkalemia within 90 days of initiating treatment.<\/jats:p>","DOI":"10.1038\/s41440-024-01894-2","type":"journal-article","created":{"date-parts":[[2024,10,31]],"date-time":"2024-10-31T03:02:03Z","timestamp":1730343723000},"page":"378-387","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk of developing hyperkalemia in patients with hypertension treated with combination antihypertensive therapy \u2013 a retrospective register-based study"],"prefix":"10.1038","volume":"48","author":[{"given":"Fatma Luai Mahdi","family":"Al-Janabi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatme","family":"Moussa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Taleb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Derek Christian","family":"Leutscher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc Meller","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorte","family":"Melgaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"S\u00f8gaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Torp-Pedersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Kragholm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luk\u00e1cs","family":"Krogager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,10,31]]},"reference":[{"key":"1894_CR1","doi-asserted-by":"publisher","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","volume":"39","author":"B Williams","year":"2018","unstructured":"Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 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