Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials

BACKGROUND: Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. METHODS AND RESULTS: We performed a meta‐analysis to explore the dose‐response relationship between potassi...

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Autores principales: Filippini, Tommaso, Naska, Androniki, Kasdagli, Maria‐Iosifina, Torres, Duarte, Lopes, Carla, Carvalho, Catarina, Moreira, Pedro, Malavolti, Marcella, Orsini, Nicola, Whelton, Paul K., Vinceti, Marco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429027/
https://www.ncbi.nlm.nih.gov/pubmed/32500831
http://dx.doi.org/10.1161/JAHA.119.015719
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author Filippini, Tommaso
Naska, Androniki
Kasdagli, Maria‐Iosifina
Torres, Duarte
Lopes, Carla
Carvalho, Catarina
Moreira, Pedro
Malavolti, Marcella
Orsini, Nicola
Whelton, Paul K.
Vinceti, Marco
author_facet Filippini, Tommaso
Naska, Androniki
Kasdagli, Maria‐Iosifina
Torres, Duarte
Lopes, Carla
Carvalho, Catarina
Moreira, Pedro
Malavolti, Marcella
Orsini, Nicola
Whelton, Paul K.
Vinceti, Marco
author_sort Filippini, Tommaso
collection PubMed
description BACKGROUND: Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. METHODS AND RESULTS: We performed a meta‐analysis to explore the dose‐response relationship between potassium supplementation and BP in randomized‐controlled trials with a duration ≥4 weeks using the recently developed 1‐stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U‐shaped relationship between 24‐hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U‐shaped relationship. The BP‐lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug‐treated hypertension but not in their untreated counterparts. CONCLUSIONS: We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.
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spelling pubmed-74290272020-08-18 Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials Filippini, Tommaso Naska, Androniki Kasdagli, Maria‐Iosifina Torres, Duarte Lopes, Carla Carvalho, Catarina Moreira, Pedro Malavolti, Marcella Orsini, Nicola Whelton, Paul K. Vinceti, Marco J Am Heart Assoc Systematic Review and Meta‐analysis BACKGROUND: Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. METHODS AND RESULTS: We performed a meta‐analysis to explore the dose‐response relationship between potassium supplementation and BP in randomized‐controlled trials with a duration ≥4 weeks using the recently developed 1‐stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U‐shaped relationship between 24‐hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U‐shaped relationship. The BP‐lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug‐treated hypertension but not in their untreated counterparts. CONCLUSIONS: We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups. John Wiley and Sons Inc. 2020-06-05 /pmc/articles/PMC7429027/ /pubmed/32500831 http://dx.doi.org/10.1161/JAHA.119.015719 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Systematic Review and Meta‐analysis
Filippini, Tommaso
Naska, Androniki
Kasdagli, Maria‐Iosifina
Torres, Duarte
Lopes, Carla
Carvalho, Catarina
Moreira, Pedro
Malavolti, Marcella
Orsini, Nicola
Whelton, Paul K.
Vinceti, Marco
Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials
title Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials
title_full Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials
title_fullStr Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials
title_full_unstemmed Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials
title_short Potassium Intake and Blood Pressure: A Dose‐Response Meta‐Analysis of Randomized Controlled Trials
title_sort potassium intake and blood pressure: a dose‐response meta‐analysis of randomized controlled trials
topic Systematic Review and Meta‐analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429027/
https://www.ncbi.nlm.nih.gov/pubmed/32500831
http://dx.doi.org/10.1161/JAHA.119.015719
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