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From The CriticsReviewer: John F. Moran, MD (Loyola University Stritch School of Medicine)
Description: This monograph reviews both the basic and clinical aspects of potassium regulation and the cardiovascular effect of potassium.
Purpose: The purpose is to explain the importance of potassium in the prevention of cardiovascular disease. This is considered dietary potassium. The author also hopes to encourage questions regarding diet and stimulate research in the area of potassium.
Audience: The author seems to be targeting the book toward leaders in research and opinion makers, but clinicians would also find it valuable, since hypertension and cardiovascular disease are so common and low levels of potassium are frequently the result of therapy with diuretics.
Features: The book is divided into two sections: the first is on the regulation of potassium in four chapters, and the second is the response of cells to potassium levels in eight chapters. There is an interesting basic science review on potassium regulation, and the role of the potassium/aldosterone/angiotensin II mechanisms. The relationship between aldosterone, which when increased can result indirectly in a potassium loss, although its primary purpose is sodium retention. In the basic science section, the author focuses on the cellular effects of potassium in regards to: platelet aggregation and thrombosis; free radical formation and LDL oxidation; and vascular smooth muscle cell proliferation and migration. There is a good review of the basic studies as well as some clinical studies on the roll of potassium in preventing cerebral vascular accidents and restenosis, post percutaneous coronary angioplasty. There is also a good section on the relation of potassium intake and blood pressure, and its importance in treating patients with hypertension. The relationship of hypokalemia to cardiac arrhythmias is well known, and is again presented here. There is some data on left ventricular function, which can be somewhat depressed in the presence of hypokalemia. In the basic science section of the book, the author uses 3-D graphs to show the interrelationship of four variables, which can be helpful. There are also tables listing the causes of hypokalemia and hyperkalemia. There are 231 references presented at the end of the text, and note of them are made throughout the entire textbook. The index is helpful. There are many graphs throughout the text which are helpful in illustrating the various points.
Assessment: There is clearly a need for some further research into the area of potassium, since it may well be one of many factors affecting these different clinical situations. The book is a nice, up-to-date collection of current research in this area.