Effects of oral potassium on blood pressure. Meta-analysis of randomized control trials

Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland, United States
JAMA The Journal of the American Medical Association (Impact Factor: 35.29). 06/1997; 277(20):1624-32. DOI: 10.1001/jama.277.20.1624
Source: PubMed


To assess the effects of supplementation with oral potassium on blood pressure in humans.
Meta-analysis of randomized controlled trials.
English-language articles published before July 1995.
Thirty-three randomized controlled trials (2609 participants) in which potassium supplementation was the only difference between the intervention and control conditions.
Using a standardized protocol, 2 of us independently abstracted information on sample size, duration, study design, potassium dose, participant characteristics, and treatment results.
By means of a random-effects model, findings from individual trials were pooled, after results for each trial were weighted by the inverse of its variance. An extreme effect of potassium in lowering blood pressure was noted in 1 trial. After exclusion of this trial, potassium supplementation was associated with a significant reduction in mean (95% confidence interval) systolic and diastolic blood pressure of -3.11 mm Hg (-1.91 to -4.31 mm Hg) and -1.97 mm Hg (-0.52 to -3.42 mm Hg), respectively. Effects of treatment appeared to be enhanced in studies in which participants were concurrently exposed to a high intake of sodium.
Our results support the premise that low potassium intake may play an important role in the genesis of high blood pressure. Increased potassium intake should be considered as a recommendation for prevention and treatment of hypertension, especially in those who are unable to reduce their intake of sodium.

87 Reads
    • "In contrast, various healthy behaviors are fairly good for low blood pressure. These include the consumption of fruits and vegetables [7] [8] as well as regular exercise [9]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background. – Providing factual data about non-communicable diseases (NCDs) is of utmost importance in the sub-Saharan African countries where NCDs and arterial hypertension data remain scattered, scarce, and less representative given the region’s heterogeneous population. Within this context, the interuniversity cooperation VLIR-UOS/Catholic University of Bukavu (Democratic Republic of Congo) has established an integrated project for monitoring hypertension and cardiovascular risk factors in the population of South Kivu. The aim of the study was to present the basic results of the determinants of blood pressure in the cohort studied. Methods. – In 2013 and 2014, trained interviewers collected the anthropometric parameters, blood pressure, and medical history of 7405 adults (3060 in urban areas and 4345 in rural areas) including 3162 males and 4243 females; the cohort is expected to be followed for 9 years. Results. – The average age of the entire group was 33.0 � 16.7 years. Compared to men, women had significantly higher obesity indices (P < 0.0001), lower blood pressure between 20 and 39 years of age (P < 0.0001) but higher blood pressure at 60 years of age and older (P < 0.0001). Blood pressure was positively correlated with body mass index, waist circumference, and paradoxically with consumption of vegetables, but negatively correlated with the consumption of fruit, intense physical activity, and relaxation at home. Conclusions. – These results show that a cohort study is feasible in the Democratic Republic of Congo. The factual data analysis can contribute to health policy orientation and setting up of preventive measures. Since most correlated risk factors are preventable, recommendations can already be made in the fight against high blood pressure in this population. Keywords: Blood pressure; Observ Study; South Kivu; Democratic Republic of Congo
    Revue d Épidémiologie et de Santé Publique 11/2015; DOI:10.1016/j.respe.2015.07.044 · 0.59 Impact Factor
  • Source
    • "Sodium excretion alone was not associated with AI however the sodium/potassium excretion ratio was indicating that the effect of diet on wave reflection appears to have been driven primarily by potassium intake in this group of subjects. These findings are novel in that potassium has primarily been associated with its BP lowering effects [3,4,26,27]. Similar to our results, other data suggest that urinary sodium is not associated with AI as well [28]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Increased potassium intake has been shown to lower blood pressure (BP) even in the presence of high sodium consumption however the role of dietary potassium on vascular function has received less attention. The aim of this study was to evaluate the relationship between habitual intake of sodium (Na) and potassium (K) and measures of arterial stiffness and wave reflection. Thirty-six young healthy adults (21 M, 15 F; 24 +/- 0.6 yrs; systolic BP 117 +/- 2; diastolic BP 63 +/- 1 mmHg) recorded their dietary intake for 3 days and collected their urine for 24 hours on the 3rd day. Carotid-femoral pulse wave velocity (PWV) and the synthesis of a central aortic pressure waveform (by radial artery applanation tonometry and generalized transfer function) were performed. Aortic augmentation index (AI), an index of wave reflection, was calculated from the aortic pressure waveform. Subjects consumed an average of 2244 kcals, 3763 mg Na, and 2876 mg of K. Average urinary K excretion was 67 +/- 5.3 mmol/24 hr, Na excretion was 157 +/- 11 mmol/24 hr and the average Na/K excretion ratio was 2.7 +/- 0.2. An inverse relationship between AI and K excretion was found (r = -0.323; p < 0.05). A positive relationship between AI and the Na/K excretion ratio was seen (r = 0.318; p < 0.05) while no relationship was noted with Na excretion alone (r = 0.071; p > 0.05). Reflection magnitude, the ratio of reflected and forward waves, was significantly associated with the Na/K excretion ratio (r = 0.365; p <0.05) but not Na or K alone. PWV did not correlate with Na or the Na/K excretion ratio (p > 0.05) but showed an inverse relationship with K excretion (r = -0.308; p < 0.05). These data suggest that lower potassium intakes are associated with greater wave reflection and stiffer arteries in young healthy adults.
    Nutrition Journal 04/2014; 13(1):39. DOI:10.1186/1475-2891-13-39 · 2.60 Impact Factor
  • Source
    • "The effect of sodium on blood pressure may, however, be modified by potassium intake or fluid intake, given their influence on blood pressure regulation and sodium homeostasis, which are both key functions of the kidney (Whelton et al, 1997; Rose and Post, 2001). That considered, potassium intake and fluid intake may individually influence RCC risk, or modify potential effects of sodium intake on RCC risk. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: As sodium, potassium and fluid intake are related to hypertension, an established risk factor for renal cell cancer (RCC), they may be independent risk factors for RCC. Methods: The Netherlands Cohort Study (NLCS) with case-cohort design included 120 852 participants aged 55–69 years. At baseline, diet and lifestyle were assessed with questionnaires. After 17.3 years of follow-up, 485 RCC cases and 4438 subcohort members were available for analyses. Results: Sodium intake increased RCC risk (P-trend=0.03), whereas fluid and potassium intake did not. For high sodium and low fluid intake, the RCC risk additionally increased (P-interaction=0.02). Conclusion: Sodium intake is a potential risk factor for RCC, particularly if fluid consumption is low.
    British Journal of Cancer 12/2013; 110(3). DOI:10.1038/bjc.2013.771 · 4.84 Impact Factor
Show more

Similar Publications