Tags

Type your tag names separated by a space and hit enter

Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses.

Abstract

OBJECTIVE

To conduct a systematic review of the literature and meta-analyses to fill the gaps in knowledge on potassium intake and health.

DATA SOURCES

Cochrane Central Register of Controlled Trials, Medline, Embase, WHO International Clinical Trials Registry Platform, Latin American and Caribbean Health Science Literature Database, and the reference lists of previous reviews.

STUDY SELECTION

Randomised controlled trials and cohort studies reporting the effects of potassium intake on blood pressure, renal function, blood lipids, catecholamine concentrations, all cause mortality, cardiovascular disease, stroke, and coronary heart disease were included.

DATA EXTRACTION AND SYNTHESIS

Potential studies were independently screened in duplicate, and their characteristics and outcomes were extracted. When possible, meta-analysis was done to estimate the effects (mean difference or risk ratio with 95% confidence interval) of higher potassium intake by using the inverse variance method and a random effect model.

RESULTS

22 randomised controlled trials (including 1606 participants) reporting blood pressure, blood lipids, catecholamine concentrations, and renal function and 11 cohort studies (127,038 participants) reporting all cause mortality, cardiovascular disease, stroke, or coronary heart disease in adults were included in the meta-analyses. Increased potassium intake reduced systolic blood pressure by 3.49 (95% confidence interval 1.82 to 5.15) mm Hg and diastolic blood pressure by 1.96 (0.86 to 3.06) mm Hg in adults, an effect seen in people with hypertension but not in those without hypertension. Systolic blood pressure was reduced by 7.16 (1.91 to 12.41) mm Hg when the higher potassium intake was 90-120 mmol/day, without any dose response. Increased potassium intake had no significant adverse effect on renal function, blood lipids, or catecholamine concentrations in adults. An inverse statistically significant association was seen between potassium intake and risk of incident stroke (risk ratio 0.76, 0.66 to 0.89). Associations between potassium intake and incident cardiovascular disease (risk ratio 0.88, 0.70 to 1.11) or coronary heart disease (0.96, 0.78 to 1.19) were not statistically significant. In children, three controlled trials and one cohort study suggested that increased potassium intake reduced systolic blood pressure by a non-significant 0.28 (-0.49 to 1.05) mm Hg.

CONCLUSIONS

High quality evidence shows that increased potassium intake reduces blood pressure in people with hypertension and has no adverse effect on blood lipid concentrations, catecholamine concentrations, or renal function in adults. Higher potassium intake was associated with a 24% lower risk of stroke (moderate quality evidence). These results suggest that increased potassium intake is potentially beneficial to most people without impaired renal handling of potassium for the prevention and control of elevated blood pressure and stroke.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • FREE Publisher Full Text
  • Authors+Show Affiliations

    ,

    Nutrition Policy and Scientific Advice Unit, Department of Nutrition for Health and Development, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. nancy.aburto@wfp.org

    , , , ,

    Source

    BMJ (Clinical research ed.) 346: 2013 Apr 03 pg f1378

    MeSH

    Blood Pressure
    Catecholamines
    Coronary Disease
    Female
    Humans
    Hypertension
    Lipid Metabolism
    Male
    Potassium, Dietary
    Randomized Controlled Trials as Topic
    Risk Factors
    Stroke

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Research Support, Non-U.S. Gov't
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23558164

    Citation

    Aburto, Nancy J., et al. "Effect of Increased Potassium Intake On Cardiovascular Risk Factors and Disease: Systematic Review and Meta-analyses." BMJ (Clinical Research Ed.), vol. 346, 2013, pp. f1378.
    Aburto NJ, Hanson S, Gutierrez H, et al. Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ. 2013;346:f1378.
    Aburto, N. J., Hanson, S., Gutierrez, H., Hooper, L., Elliott, P., & Cappuccio, F. P. (2013). Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ (Clinical Research Ed.), 346, pp. f1378. doi:10.1136/bmj.f1378.
    Aburto NJ, et al. Effect of Increased Potassium Intake On Cardiovascular Risk Factors and Disease: Systematic Review and Meta-analyses. BMJ. 2013 Apr 3;346:f1378. PubMed PMID: 23558164.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. AU - Aburto,Nancy J, AU - Hanson,Sara, AU - Gutierrez,Hialy, AU - Hooper,Lee, AU - Elliott,Paul, AU - Cappuccio,Francesco P, Y1 - 2013/04/03/ PY - 2013/4/6/entrez PY - 2013/4/6/pubmed PY - 2013/5/29/medline SP - f1378 EP - f1378 JF - BMJ (Clinical research ed.) JO - BMJ VL - 346 N2 - OBJECTIVE: To conduct a systematic review of the literature and meta-analyses to fill the gaps in knowledge on potassium intake and health. DATA SOURCES: Cochrane Central Register of Controlled Trials, Medline, Embase, WHO International Clinical Trials Registry Platform, Latin American and Caribbean Health Science Literature Database, and the reference lists of previous reviews. STUDY SELECTION: Randomised controlled trials and cohort studies reporting the effects of potassium intake on blood pressure, renal function, blood lipids, catecholamine concentrations, all cause mortality, cardiovascular disease, stroke, and coronary heart disease were included. DATA EXTRACTION AND SYNTHESIS: Potential studies were independently screened in duplicate, and their characteristics and outcomes were extracted. When possible, meta-analysis was done to estimate the effects (mean difference or risk ratio with 95% confidence interval) of higher potassium intake by using the inverse variance method and a random effect model. RESULTS: 22 randomised controlled trials (including 1606 participants) reporting blood pressure, blood lipids, catecholamine concentrations, and renal function and 11 cohort studies (127,038 participants) reporting all cause mortality, cardiovascular disease, stroke, or coronary heart disease in adults were included in the meta-analyses. Increased potassium intake reduced systolic blood pressure by 3.49 (95% confidence interval 1.82 to 5.15) mm Hg and diastolic blood pressure by 1.96 (0.86 to 3.06) mm Hg in adults, an effect seen in people with hypertension but not in those without hypertension. Systolic blood pressure was reduced by 7.16 (1.91 to 12.41) mm Hg when the higher potassium intake was 90-120 mmol/day, without any dose response. Increased potassium intake had no significant adverse effect on renal function, blood lipids, or catecholamine concentrations in adults. An inverse statistically significant association was seen between potassium intake and risk of incident stroke (risk ratio 0.76, 0.66 to 0.89). Associations between potassium intake and incident cardiovascular disease (risk ratio 0.88, 0.70 to 1.11) or coronary heart disease (0.96, 0.78 to 1.19) were not statistically significant. In children, three controlled trials and one cohort study suggested that increased potassium intake reduced systolic blood pressure by a non-significant 0.28 (-0.49 to 1.05) mm Hg. CONCLUSIONS: High quality evidence shows that increased potassium intake reduces blood pressure in people with hypertension and has no adverse effect on blood lipid concentrations, catecholamine concentrations, or renal function in adults. Higher potassium intake was associated with a 24% lower risk of stroke (moderate quality evidence). These results suggest that increased potassium intake is potentially beneficial to most people without impaired renal handling of potassium for the prevention and control of elevated blood pressure and stroke. SN - 1756-1833 UR - https://www.unboundmedicine.com/medline/citation/23558164/Effect_of_increased_potassium_intake_on_cardiovascular_risk_factors_and_disease:_systematic_review_and_meta_analyses_ L2 - http://www.bmj.com/cgi/pmidlookup?view=long&pmid=23558164 DB - PRIME DP - Unbound Medicine ER -