Hypertension

HTN: Potassium (2015)

• Intervention
  What is the relationship between potassium intake from food sources and blood pressure in adults with hypertension?

  • Conclusion
    Results from six of eight studies showed a significant inverse relationship between potassium intake from food sources and blood pressure (BP) in adults with hypertension. Potassium excretion as a marker of dietary intake was inversely associated with BP in four of five studies. In one of two dietary intervention studies, increasing potassium intake up to 2,000mg above baseline increased the likelihood of diastolic blood pressure control.
  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between potassium intake from food sources and blood pressure in adults with hypertension?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Berry SE, Mulla UZ, Chowienczyk PJ, Sanders TAB. Increased potassium intake from fruit and vegetables or supplements does not lower blood pressure or improve vascular function in UK men and women with early hypertension: A randomised controlled trial. Br J Nutr. 2010; 104: 1,839-1,847.
      • Cheung BMY, Ho SPC, Cheung AHK, Lau CP. Diastolic blood pressure is related to urinary sodium excretion in hypertensive Chinese patients.  Q J Med. 2000; 93: 163-168.
      • Espeland MA, Kumanyika S, Yunis C, Zheng B, Brown WM, Jackson S, Wilson AC, Bahnson J, Electrolyte intake and nonpharmacologic blood pressure control. Ann Epidemiol. 2002; 12: 587-595. 
      • Hedayati SS, Minhajuddin AT, Ijaz A, Moe OW, Elsayed EF, Reilly RF, Huang CL. Association of urinary sodium/potassium ratio with blood pressure: sex and racial differences. Clin J Am Soc Nephrol. 2012; 7 (2): 315-322.
      • Hu G, Tian H. A comparison of dietary and non-dietary factors of hypertension and normal blood pressure in a Chinese population. J Hum Hypertens. 2001; (15) 7: 487-493.
      • Kwok TCY, Chan TYK, Woo J. Relationship of urinary sodium/potassium excretion and calcium intake to blood pressure and prevalence of hypertension among older Chinese vegetarians. European Journal of Clinical Nutrition, 2003; 57: 299-304.
      • Lancaster KJ, Smiciklas-Wright H, Weltzel LB, Mitchell DC, Friedman JM, Jensen GL. Hypertension-related dietary patterns of rural older adults. Preventive Medicine, 2004; 38: 812-818.
      • Schroder H, Schmelz E, Marrugat J. Relationship between diet and blood pressure in a representative Mediterranean population. Eur J Nutr. 2002; 41 (4): 161-167. 
  • Search Plan and Results: HTN: Minerals (Potassium) 2014
     
  What is the relationship between potassium intake from supplements and blood pressure in adults with hypertension?

  • Conclusion
    In four of seven studies of adults with hypertension, potassium supplementation of up to approximately 3,700 mg reduced systolic blood pressure and diastolic blood pressure by three to 13mmHg and zero to eight mmHg, respectively.
    
     
  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between potassium intake from supplements and blood pressure in adults with hypertension?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Berry SE, Mulla UZ, Chowienczyk PJ, Sanders TAB. Increased potassium intake from fruit and vegetables or supplements does not lower blood pressure or improve vascular function in UK men and women with early hypertension: A randomised controlled trial. Br J Nutr. 2010; 104: 1,839-1,847.
      • China Salt Substitute Study Collaborative Group. Salt substitution: A low-cost strategy for blood pressure control among rural Chinese. A randomized, controlled trial. J Hypertens. 2007 Oct; 25 (10): 2,011-2,018.
      • Dickinson HO, Nicolson DJ, Campbell F, Beyer FR, Mason J. Potassium supplementation for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2006 Jul 19; 3.
      • Franzoni F, Santoro G, Carpi A, DaPrato F, Bartolomucci F, Femia FR, Prattichizzo F, Galetta F. Antihypertensive effect of oral potassium aspartate supplementation in mild to moderate arterial hypertension. Biomedicine & Pharmacotherapy. 2005; 59: 25-29.
      • He FJ, Marciniak M, Carney C, Markandu ND, Anand V, Fraser WD, Dalton RN, Kaski JC, MacGregor GA. Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives. Hypertension. 2010; 55: 681-688. 
      • He FJ, Markandu ND, Coltart R, Barron J, MacGregor GA. Effect of short-term supplementation of potassium chloride and potassium citrate on blood pressure in hypertensives. Hypertension. 2005 Apr; 45(4): 571-574.  
      • He J, Gu D, Chen J, Jaquish CE, Rao DC, Hixson JE, Chen JC, Duan X, Huang JF, Chen CS, Kelly TN, Bazzano LA, Whelton PK; GenSalt Collaborative Research Group. Gender difference in blood pressure responses to dietary sodium intervention in the GenSalt study. J Hypertens. 2009 Jan; 27(1): 48-54.
         
      • Kelly TN, Gu D, Rao DC, Chen J, Chen J, Cao J, Li J, Lu F, Ma J, Mu J, Whelton PK, He J. Maternal history of hypertension and blood pressure response to potassium intake. The GenSalt Study. Am J Epidemiol. 2012; 176(Suppl 7): S55-S63.
  • Search Plan and Results: HTN: Minerals (Potassium) 2014