Licorice and Hypertension

To the Editor:—  Two recently observed patients with hypertension again point out the prime importance of a detailed history, especially a question with regard to the intake of licorice or licorice-containing products in patients with hypertension. A 55-year-old woman with previously normal blood pressure presented with a blood pressure of 180/110. The patient was placed on a regimen of one tablet of a cryptenamine and a chlorothiazide derivative mixture (Diutensen) daily. About a week later she was found to be paralyzed and unable to move all four extremities. Hypokalemia was suspected and indeed found (2.2 mEq/liter). For the preceding six months this patient had been ingesting one package of licorice candy every night as an aid to the treatment of constipation. The hypokalemia and the paralysis were undoubtedly increased by the use of the chlorothiazide drug even though licorice itself can cause both the hypokalemia and the paralysis. The paralysis