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The effect of low-dose potassium supplementation on blood pressure in apparently healthy volunteers

Published online by Cambridge University Press:  07 June 2007

Donald J. Naismith  and
Alessandro Braschi
Donald J. Naismith
Affiliation:
Department of Nutrition and Dietetics, King' College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 8WD, UK
Alessandro Braschi*
Affiliation:
Department of Nutrition and Dietetics, King' College London, Franklin-Wilkins Building, 150 Stamford Street, London SE1 8WD, UK
*
*Corresponding author: Professor Donald J. Naismith, fax +44 20 7333 4285, email [email protected]
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Abstract

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Epidemiological and clinical trials suggest an inverse relationship between dietary K intake and blood pressure (BP). Most trials however have been of short duration, the dose of K was high, and the results have been conflicting. The aim of the present study was to evaluate the effect on BP of a low-dose supplementation (24 mmol/d) for an extended period. A double-blind placebo-controlled trial was conducted on fifty-nine volunteers, randomly assigned to receive 24 mmol slow-release KC1/d (n 30) or a placebo (n 29). Measures of BP, anthropometric characteristics and urine analysis for electrolytes were recorded during a 1-week baseline period. Supplementation was for 6 weeks during which BP and changes in weight were assessed and a second 24h urine collection made. The primary outcome was the change in mean arterial pressure (MAP); systolic BP(SBP) and diastolic BP(DBP) were secondary outcomes. After 6 weeks of supplementation MAP was reduced by 7·01 (95% CI −9·12, −4·89; P<0·001) mmHg, SBP was reduced by 7·60 (95% CI −10·46, −4·73; P<0·001) mmHg and DBP was reduced by 6·46 (95% CI −8·74, −4·19; P<0·001) mmHg. The reduction in MAP was positively associated with baseline urinary Na:K (P<0·034). A low daily dietary supplement of K, equivalent to the content of five portions of fresh fruits and vegetables, induced a substantial reduction in MAP, similar in effect to single-drug therapy for hypertension.

Keywords

Blood pressurePotassiumClinical trialsDiet
Type
Research Article
Information
British Journal of Nutrition , Volume 90 , Issue 1 , July 2003 , pp. 53 - 60
Copyright
Copyright © The Nutrition Society 2003

References

Appel, LJ, Moore, TJ, Obarzanek, E, et al. (1997) A clinical trial of the effects of dietary patterns on blood pressure. N Engl J Med 336, 1117–1124.CrossRefGoogle ScholarPubMed
Bates, CJ, Prentice, A, Cole, TJ, et al. (1999) Micronutrients: highlights and research challenges from the 1994–5 National Diet and Nutrition Survey of people aged 65 years and over. Brit J Nutr 82, 7–15.CrossRefGoogle ScholarPubMed
Beevers, G, Lip, GYH & O'Brien, E (2001 a) ABC of hypertension. Blood pressure measurement. Part I. Sphygmomanometry: factors common to all techniques. BMJ 322, 981–985.Google Scholar
Beevers, G, Lip, GYH & O'Brien, E (2001 b) ABC of hypertension. Blood pressure measurement. Part II. Conventional sphygmomanometry: technique of ascultatory blood pressure measurement. BMJ 322, 1043–1047.CrossRefGoogle Scholar
Boegehold, MA & Kotchen, TA (1991) Importance of dietary chloride for salt sensitivity of blood pressure. Hypertension 17 Suppl. 1, 158–161.CrossRefGoogle ScholarPubMed
Cappuccio, FP & MacGregor, GA (1991) Does potassium supplementation lower blood pressure? A meta-analysis of published trials. J Hypertens 9, 465–473.Google Scholar
Carrettero, OA & Oparil, S (2000) Essential Hypertension. Part I: Definition and Etiology. Circulation 101, 329–335.Google Scholar
Department of Health (1991) Dietary Reference Values for Food Energy and Nutrients for the United Kingdom. Report on Health and Social Subjects no. 41, pp. 152–160. London: H.M. Stationery Office.Google Scholar
Dyer, AR, Elliott, P, Shipley, M, et al. (1994) Body Mass Index and Association of Sodium and Potassium With Blood Pressure in INTERSALT. Hypertension 23, 729–736.CrossRefGoogle ScholarPubMed
Fotherby, MD & Potter, JF (1997) Long-term potassium supplementation lowers blood pressure in elderly hypertensive subjects. Int J Clin Pract 51, 219–222.CrossRefGoogle ScholarPubMed
Freedman, DA & Petitti, DB (2001) Salt and blood pressure. Conventional wisdom reconsidered. Eval Rev 25, 267–287.CrossRefGoogle ScholarPubMed
Frisancho, AR, Lennard, WR & Bollettino, LA (1984) Blood pressure in blacks and whites and its relationship to dietary sodium and potassium intake. J Chronic Dis 37, 515–519.CrossRefGoogle ScholarPubMed
Geleijnse, JM, Grobbe, DE & Hofman, A (1990) Sodium and potassium intake and blood pressure change in childhood. BMJ 300, 899–902.Google Scholar
Giaconi, S, Ghione, S & Palombo, C, et al. (1989) Seasonal influences on blood pressure in high normal to mild hypertensive range. Hypertension 14, 22–27.CrossRefGoogle ScholarPubMed
Graudal, NA, Galløe, AM & Garred, P (1998) Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride: a meta-analysis. JAMA 279, 1383–1391.Google Scholar
Gregory, J, Foster, K, Tyler, H & Wiseman, M (1990) The Dietary and Nutritional Survey of British Adults, pp 154–158. London: H.M. Stationery Office.Google Scholar
Hypertension Prevention Trial Research Group (1990) The Hypertension Prevention Trial: Three-year effects of dietary changes on blood pressure. Arch Intern Med 150, 153–162.CrossRefGoogle Scholar
Intersalt Cooperative Research Group (1988) Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24hour sodium and potassium excretion. BMJ 297, 319–328.CrossRefGoogle Scholar
Jansen, PM, Leineweber, MJ & Thien, T (2001) The effect of a change in ambient temperature on blood pressure in normotensives. J Hum Hypertens 15, 113–117.Google Scholar
Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (1997) The sixth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Arch Intern Med 157, 2413–2446.CrossRefGoogle Scholar
Kannel, WB (1996) Blood pressure as a cardiovascular risk factor. JAMA 275, 1571–1576.CrossRefGoogle ScholarPubMed
Kawano, Y, Minami, J, Takishita, S & Omae, T (1998) Effects of Potassium Supplementation on Office, Home, and 24-h Blood Pressure in Patients with Essential Hypertension. Am J Hypertens 11, 141–146.CrossRefGoogle ScholarPubMed
Kotchen, TA & Kotchen, JM (1997) Dietary sodium and blood pressure: interactions with other nutrients. Am J Clin Nutr 65 Suppl. 2, 708S–711S.Google Scholar
Langford, HG (1983) Dietary potassium and hypertension: Epidemiologic data. Ann Intern Med 98, 770–772.Google Scholar
Materson, BJ, Reda, DJ & Cushman, WC, et al. (1993) Single-drug therapy for hypertension in men: a comparison of six antihypertensive agents with placebo. N Engl J Med 328, 914–921 (Erratum, N Engl J Med (1994) 330, 1689)CrossRefGoogle Scholar
Matlou, SM, Isles, CG & Higgs, A et al. (1986) Potassium supplementation in blacks with mild to moderate hypertension. J Hypertens 4, 61–64.CrossRefGoogle Scholar
Medline plus (2002) Medline plus Drug information: Potassium Supplements (systemic), accessed 7 February 2002. http://www.nlm.nih.gov/medlineplus/druginfo/potassiumsupplementssystemic202473.htlmGoogle Scholar
JrMorris, RC, Sebastian, A, Forman, A, Tanaka, M & Schmidlin, O (1999) Normotensive salt sensitivity: effects of race and dietary potassium. Hypertension 33, 18–23.CrossRefGoogle ScholarPubMed
O'Brien, E, Beevers, G & Lip, GYH (2001 a) ABC of hypertension. Blood pressure measurement. Part IV. Automated sphygmomanometry: self blood pressure measurement. BMJ 322, 1167–1170.CrossRefGoogle ScholarPubMed
O'Brien, E, Waeber, B, Parati, G, et al. (2001 b) Blood pressure measuring devices: recommendations of the European Society of Hypertension. BMJ 322, 531–536.CrossRefGoogle ScholarPubMed
Primatesta, P, Brookes, M & Poulter, NR (2001) Improved Hypertension Management and Control: results from the health survey for England. Hypertension 38, 827–832.CrossRefGoogle ScholarPubMed
Psaty, BM, Furberg, CD, Kuller, LH, et al. (2001) Association Between Blood Pressure Level and Risk of Myocardial Infarction, Stroke, and Total Mortality. Arch Intern Med 161, 1183–1192.Google Scholar
Rouse, IL, Beilin, LJ, Armstrong, BK & Vandogen, R (1983) Blood pressure lowering effect of a vegetarian diet: controlled trial in normotensive subjects. Lancet i, 5–10.CrossRefGoogle Scholar
Sacks, FM & Kass, EH (1988) Low Blood pressure in Vegetarians: effects of specific foods and nutrients. Am J Clin Nutr 48 Suppl. 3, 795–800.CrossRefGoogle ScholarPubMed
Sacks, FM, Svetkey, LP, Vollmer, WM, et al. (2001) Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 344, 3–10.CrossRefGoogle ScholarPubMed
Sesso, HD, Stampfer, MJ, Rosner, B, et al. (2000) Systolic and Diastolic Blood Pressure, Pulse Pressure, and Mean Arterial Pressure as Predictors of Cardiovascular Disease Risk in Men. Hypertension 36, 801–807.CrossRefGoogle ScholarPubMed
Shore, AC, Markandu, ND & MacGregor, GA (1988) A randomized crossover study to compare the blood pressure response to sodium loading with and without chloride in patients with essential hypertension. J Hypertens 6, 613–617.CrossRefGoogle ScholarPubMed
Siani, A, Strazzullo, P, Russo, L, et al. (1987) Controlled trial of long term oral potassium supplements in patients with mild hypertension. BMJ 294, 1453–1456.CrossRefGoogle ScholarPubMed
Sinaiko, AR, Gomez-Marin, O & Prineas, RJ (1993) Effect of low sodium diet or potassium supplementation on adolescent blood pressure. Hypertension 21, 989–994.CrossRefGoogle ScholarPubMed
Smith, GD & Brunner, E (1997) Socio-economic differentials in health: the role of nutrition. Proc Nutr Soc 56, 75–90.CrossRefGoogle ScholarPubMed
Vander, A, Sherman, J & Luciano, D (2000) Human Physiology. The Mechanism of Body Function. eight ed. pp. 407–416 and pp. 626–634. New York, NY: McGraw-Hill.Google Scholar
Ward, RH, Chin, PG & Prior, IA (1980) Tokelau Island Migrant Study: Effects of migration on the familial aggregation of blood pressure. Hypertension 2 Suppl. 1, 43–54.Google Scholar
Whelton, PK, He, J, Cutler, JA, et al. (1997) Effects of Oral Potassium on Blood Pressure. Meta-analysis of Randomized Controlled Clinical Trials. JAMA 277, 1624–1632.CrossRefGoogle ScholarPubMed
Wilson, DK, Sica, DA & Miller, SB (1999) Effects of Potassium on Blood Pressure in Salt-Sensitive and Salt-Resistant Black Adolescents. Hypertension 34, 181–186.Google Scholar