Potassium, Blood Pressure, and Cardiovascular Disease

Results from both observational epidemiologic studies and randomized controlled trials suggest an inverse relationship between potassium intake and blood pressure in human populations. In isolated populations, mean blood pressure is low and does not rise or rises little with age. Typically, these populations consume a diet that is low in sodium and high in potassium. Data from the Intersalt study, a cross-sectional study of 10,079 men and women aged 20 to 59 from 52 populations around the world indicate that a 50 mmol/day higher level of urinary potassium excretion was associated with a −3.4 [95% confidence interval (Cl) −1.5 to −5.2] mmHg lower level of systolic and −1.9 (95% Cl: −0.7 to −3.0) mmHg lower level of diastolic blood pressure. A pooled analysis of results from 33 randomized controlled trials indicates that potassium supplementation (median = 53 mmol/day) was associated with a significant reduction in systolic and diastolic blood pressure of −3.1 (95% Cl: −1.9 to −4.3) and −2.0 (95% Cl: −0.5 to −3.4) mmHg, respectively. The relationship of potassium intake to blood pressure was modified by hypertension status, race, and sodium intake. Data from observational epiderniologic studies have also suggested a protective effect of dietary potassium intake on stroke mortality. The available evidence suggests that potassium supplementation should be included as part of the recommendations for treatment and prevention of hypertension.