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Potassium supplementation for the management of primary hypertension in adults.
Cochrane Database Syst Rev. 2006 Jul 19CD

Abstract

BACKGROUND

Epidemiological evidence on the effects of potassium on blood pressure is inconsistent.

OBJECTIVES

To evaluate the effects of potassium supplementation on health outcomes and blood pressure in people with elevated blood pressure.

SEARCH STRATEGY

We searched the Cochrane Library, MEDLINE, EMBASE, Science Citation Index, ISI Proceedings, ClinicalTrials.gov, Current Controlled Trials, CAB abstracts, and reference lists of systematic reviews, meta-analyses and randomised controlled trials (RCTs) included in the review.

SELECTION CRITERIA

Inclusion criteria were: 1) RCTs of a parallel or crossover design comparing oral potassium supplements with placebo, no treatment, or usual care; 2) treatment and follow-up >=8 weeks; 3) participants over 18 years, with raised systolic blood pressure (SBP) >=140 mmHg or diastolic blood pressure (DBP) >=85 mmHg); 4) SBP and DBP reported at end of follow-up. We excluded trials where: participants were pregnant; received antihypertensive medication which changed during the study; or potassium supplementation was combined with other interventions.

DATA COLLECTION AND ANALYSIS

Two reviewers independently extracted data and assessed trial quality. Disagreements were resolved by discussion or a third reviewer. Random effects meta-analyses and sensitivity analyses were conducted.

MAIN RESULTS

Six RCT's (n=483), with eight to 16 weeks follow-up, met our inclusion criteria. Meta-analysis of five trials (n=425) with adequate data indicated that potassium supplementation compared to control resulted in a large but statistically non-significant reductions in SBP (mean difference: -11.2, 95% CI: -25.2 to 2.7) and DBP (mean difference: -5.0, 95% CI: -12.5 to 2.4). The substantial heterogeneity between trials was not explained by potassium dose, quality of trials or baseline blood pressure. Excluding one trial in an African population with very high baseline blood pressure resulted in smaller overall reductions in blood pressure (SBP mean difference: -3.9, 95% CI: -8.6 to 0.8; DBP mean difference: -1.5, 95% CI: -6.2 to 3.1). Further sensitivity analysis restricted to two high quality trials (n=138) also found non-significant reductions in blood pressure (SBP mean difference: -7.1, 95% CI: -19.9 to 5.7; DBP mean difference: -5.5, 95% CI: -14.5 to 3.5).

AUTHORS' CONCLUSIONS

This systematic review found no statistically significant effect of potassium supplementation on blood pressure. Because of the small number of participants in the two high quality trials, the short duration of follow-up, and the unexplained heterogeneity between trials, the evidence about the effect of potassium supplementation on blood pressure is not conclusive. Further high quality RCTs of longer duration are required to clarify whether potassium supplementation can reduce blood pressure and improve health outcomes.

Links

Publisher Full Text

Authors

Dickinson HO
No affiliation info available
Nicolson DJ
No affiliation info available
Campbell F
No affiliation info available
Beyer FR
No affiliation info available
Mason J
No affiliation info available

MeSH

AdultBlood PressureDietary SupplementsHumansHypertensionPotassium, DietaryRandomized Controlled Trials as Topic

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

16856053

Citation

Dickinson, H O., et al. "Potassium Supplementation for the Management of Primary Hypertension in Adults." The Cochrane Database of Systematic Reviews, 2006, p. CD004641.
Dickinson HO, Nicolson DJ, Campbell F, et al. Potassium supplementation for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2006.
Dickinson, H. O., Nicolson, D. J., Campbell, F., Beyer, F. R., & Mason, J. (2006). Potassium supplementation for the management of primary hypertension in adults. The Cochrane Database of Systematic Reviews, (3), CD004641.
Dickinson HO, et al. Potassium Supplementation for the Management of Primary Hypertension in Adults. Cochrane Database Syst Rev. 2006 Jul 19;(3)CD004641. PubMed PMID: 16856053.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potassium supplementation for the management of primary hypertension in adults. AU - Dickinson,H O, AU - Nicolson,D J, AU - Campbell,F, AU - Beyer,F R, AU - Mason,J, Y1 - 2006/07/19/ PY - 2006/7/21/pubmed PY - 2006/10/17/medline PY - 2006/7/21/entrez SP - CD004641 EP - CD004641 JF - The Cochrane database of systematic reviews JO - Cochrane Database Syst Rev IS - 3 N2 - BACKGROUND: Epidemiological evidence on the effects of potassium on blood pressure is inconsistent. OBJECTIVES: To evaluate the effects of potassium supplementation on health outcomes and blood pressure in people with elevated blood pressure. SEARCH STRATEGY: We searched the Cochrane Library, MEDLINE, EMBASE, Science Citation Index, ISI Proceedings, ClinicalTrials.gov, Current Controlled Trials, CAB abstracts, and reference lists of systematic reviews, meta-analyses and randomised controlled trials (RCTs) included in the review. SELECTION CRITERIA: Inclusion criteria were: 1) RCTs of a parallel or crossover design comparing oral potassium supplements with placebo, no treatment, or usual care; 2) treatment and follow-up >=8 weeks; 3) participants over 18 years, with raised systolic blood pressure (SBP) >=140 mmHg or diastolic blood pressure (DBP) >=85 mmHg); 4) SBP and DBP reported at end of follow-up. We excluded trials where: participants were pregnant; received antihypertensive medication which changed during the study; or potassium supplementation was combined with other interventions. DATA COLLECTION AND ANALYSIS: Two reviewers independently extracted data and assessed trial quality. Disagreements were resolved by discussion or a third reviewer. Random effects meta-analyses and sensitivity analyses were conducted. MAIN RESULTS: Six RCT's (n=483), with eight to 16 weeks follow-up, met our inclusion criteria. Meta-analysis of five trials (n=425) with adequate data indicated that potassium supplementation compared to control resulted in a large but statistically non-significant reductions in SBP (mean difference: -11.2, 95% CI: -25.2 to 2.7) and DBP (mean difference: -5.0, 95% CI: -12.5 to 2.4). The substantial heterogeneity between trials was not explained by potassium dose, quality of trials or baseline blood pressure. Excluding one trial in an African population with very high baseline blood pressure resulted in smaller overall reductions in blood pressure (SBP mean difference: -3.9, 95% CI: -8.6 to 0.8; DBP mean difference: -1.5, 95% CI: -6.2 to 3.1). Further sensitivity analysis restricted to two high quality trials (n=138) also found non-significant reductions in blood pressure (SBP mean difference: -7.1, 95% CI: -19.9 to 5.7; DBP mean difference: -5.5, 95% CI: -14.5 to 3.5). AUTHORS' CONCLUSIONS: This systematic review found no statistically significant effect of potassium supplementation on blood pressure. Because of the small number of participants in the two high quality trials, the short duration of follow-up, and the unexplained heterogeneity between trials, the evidence about the effect of potassium supplementation on blood pressure is not conclusive. Further high quality RCTs of longer duration are required to clarify whether potassium supplementation can reduce blood pressure and improve health outcomes. SN - 1469-493X UR - https://www.unboundmedicine.com/medline/citation/16856053/Potassium_supplementation_for_the_management_of_primary_hypertension_in_adults_ L2 - https://doi.org/10.1002/14651858.CD004641.pub2 DB - PRIME DP - Unbound Medicine ER -