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...
Autores principales: | , , , , , , , , , , |
---|---|
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 |
_version_ | 1783571204945215488 |
---|---|
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. |
format | Online Article Text |
id | pubmed-7429027 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT filippinitommaso potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT naskaandroniki potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT kasdaglimariaiosifina potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT torresduarte potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT lopescarla potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT carvalhocatarina potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT moreirapedro potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT malavoltimarcella potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT orsininicola potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT wheltonpaulk potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials AT vincetimarco potassiumintakeandbloodpressureadoseresponsemetaanalysisofrandomizedcontrolledtrials |