Using ACE inhibitors during exercise increases the risk of which electrolyte abnormality, especially with diuretics?

Using ACE inhibitors during exercise increases the risk of which electrolyte abnormality, especially with diuretics?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hyponatremia

Answer: (C)

ACE inhibitors can raise potassium levels because they reduce angiotensin II–stimulated aldosterone release, leading to less potassium being excreted in the kidney. During exercise, potassium is released from muscle cells into the bloodstream, which can further elevate serum potassium. When diuretics are added, especially potassium-sparing ones, this effect is amplified, increasing the risk of hyperkalemia. So, the electrolyte abnormality most likely to occur is elevated potassium. The other options aren’t the primary concern with this drug combination: ACE inhibitors don’t typically cause hypernatremia or hyponatremia, and while diuretics can affect potassium, the key interaction with ACE inhibitors is potassium retention rather than potassium loss.

ACE inhibitors can raise potassium levels because they reduce angiotensin II–stimulated aldosterone release, leading to less potassium being excreted in the kidney. During exercise, potassium is released from muscle cells into the bloodstream, which can further elevate serum potassium. When diuretics are added, especially potassium-sparing ones, this effect is amplified, increasing the risk of hyperkalemia.

So, the electrolyte abnormality most likely to occur is elevated potassium. The other options aren’t the primary concern with this drug combination: ACE inhibitors don’t typically cause hypernatremia or hyponatremia, and while diuretics can affect potassium, the key interaction with ACE inhibitors is potassium retention rather than potassium loss.