scholarly journals Diet or Additional Supplement to Increase Potassium Intake: Protocol For An Adaptive Clinical Trial

2021 ◽  
Author(s):  
Swapnil Hiremath ◽  
Dean Fergusson ◽  
Greg Knoll ◽  
Tim Ramsay ◽  
Jennifer Kong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Clinical Trial ◽  
High Blood Pressure ◽  
Sodium Intake ◽  
Western World ◽  
Dietary Advice ◽  
Ageing Population ◽  
Potassium Supplement ◽  
Participant Satisfaction ◽  
Potassium Intake

Abstract Background High blood pressure is the leading cause of cardiovascular disease worldwide. The prevalence of high blood pressure is steadily rising, with the growing and ageing population. Many medicines are available to decrease blood pressures successfully, as well as many non-medical options, such as dietary changes and exercise. There is a marked preference amongst patients, reiterated in a Hypertension Canada report, for more research into methods for controlling blood pressure without medicines or to reduce the burden of taking many pills to control high blood pressure. Indeed, effective options do exist, especially with diet, specifically decreasing sodium and increasing potassium in diet. Current public health outreach mostly focusses on sodium intake, even as the potassium intake in diet remains low especially in the Western world. Excellent data exist in the published research reporting that increasing potassium intake, either as diet or even as supplements, reduces blood pressure and reduces risk of cardiovascular outcomes such as stroke. However, the advice most often provided is to ‘eat more fruits and vegetables’ which does not get translated into concrete change. Methods We propose to do a clinical trial in two stages, with an adaptive trial design. In the first stage, participants with high blood pressure and proven low potassium intake (measured on the basis of a 24 hour urine collection) will get individually tailored dietary advice, reinforced by weekly supportive phone/email support. If at 4 weeks, there has not been a desired increase in potassium intake, they will be prescribed an additional potassium supplement. Testing will be conducted again at 4 weeks post initiating the potassium supplement, to confirm the efficacy of the potassium supplement. Final measurements will be planned at 52 weeks to observe and measure the persistence of the effect of diet or additional supplement. Concurrent measurements of sodium intake, blood pressure, participant satisfaction, and safety measures will also be done. Discussion The results of the study would help determine the most effective method of increasing potassium intake, thus reducing blood pressure, need for blood pressure lowering medicines, at the same time potentially increasing participant satisfaction. The current guidelines recommend changes in diet, not supplement, to increase potassium intake, hence the two stage design will only add supplements if the most rigorous dietary advice does not work. Trial registration: This study has been registered on ClinicalTrials.gov identifier NCT03809884, registered on January 18, 2019. URL: https://clinicaltrials.gov/ct2/show/NCT03809884

scholarly journals Effects of recommendations to follow the Dietary Approaches to Stop Hypertension (DASH) diet v. usual dietary advice on childhood metabolic syndrome: a randomised cross-over clinical trial

2013 ◽  
Vol 110 (12) ◽  
pp. 2250-2259 ◽  
Author(s):  
Parvane Saneei ◽  
Mahin Hashemipour ◽  
Roya Kelishadi ◽  
Somayeh Rajaei ◽  
Ahmad Esmaillzadeh
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Clinical Trial ◽  
Waist Circumference ◽  
Vitamin C ◽  
High Blood Pressure ◽  
Adolescent Girls ◽  
Dietary Advice ◽  
Dash Diet

The effects of the Dietary Approaches to Stop Hypertension (DASH) eating plan on childhood metabolic syndrome (MetS) and insulin resistance remain to be determined. The present study aimed to assess the effects of recommendations to follow the DASH diet v. usual dietary advice (UDA) on the MetS and its features in adolescents. In this randomised cross-over clinical trial, sixty post-pubescent adolescent girls with the MetS were randomly assigned to receive either the recommendations to follow the DASH diet or UDA for 6 weeks. After a 4-week washout period, the participants were crossed over to the alternate arm. The DASH group was recommended to consume a diet rich in fruits, vegetables and low-fat dairy products and low in saturated fats, total fats and cholesterol. UDA consisted of general oral advice and written information about healthy food choices based on healthy MyPlate. Compliance was assessed through the quantification of plasma vitamin C levels. In both the groups, fasting venous blood samples were obtained at baseline and at the end of each phase of the intervention. The mean age and weight of the participants were 14·2 (sd 1·7) years and 69 (sd 14·5) kg, respectively. Their mean BMI and waist circumference were 27·3 kg/m2 and 85·6 cm, respectively. Serum vitamin C levels tended to be higher in the DASH phase than in the UDA phase (860 (se 104) v. 663 (se 76) ng/l, respectively, P= 0·06). Changes in weight, waist circumference and BMI were not significantly different between the two intervention phases. Although changes in systolic blood pressure were not statistically significant between the two groups (P= 0·13), recommendations to follow the DASH diet prevented the increase in diastolic blood pressure compared with UDA (P= 0·01). We found a significant within-group decrease in serum insulin levels (101·4 (se 6·2) v. 90·0 (se 5·5) pmol/l, respectively, P= 0·04) and a non-significant reduction in the homeostasis model assessment for insulin resistance score (P= 0·12) in the DASH group. Compared with the UDA group, the DASH group experienced a significant reduction in the prevalence of the MetS and high blood pressure. Recommendations to follow the DASH eating pattern for 6 weeks among adolescent girls with the MetS led to reduced prevalence of high blood pressure and the MetS and improved diet quality compared with UDA. This type of healthy diet can be considered as a treatment modality for the MetS and its components in children.

scholarly journals Effect of the addition of psyllium (Plantago Ovata Forsk) on the total and bioaccessible concentration of the minerals sodium and potassium in frozen banana pulp

2021 ◽  
Vol 10 (8) ◽  
pp. e10410816949
Author(s):  
Elisangela Aparecida Nazario Franco ◽  
Davy William Hidalgo Chávez ◽  
Carlos Alberto Kenji Taniguchi ◽  
Antonia Barbosa de Lima ◽  
Maria do Socorro Rocha Bastos ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Blood Pressure ◽  
Sodium Intake ◽  
In Vitro Digestion ◽  
World Health ◽  
Soluble Fiber ◽  
Potassium Intake ◽  
Sodium And Potassium

Increased blood pressure is one of the main risk factors for cardiovascular disease. The World Health Organization (WHO) recommends that sodium intake should be moderate and potassium intake can be increased, as its intake is associated with a lower incidence of cardiovascular disease. Banana is a fruit rich in potassium and has large post-harvest losses due to its perishability. The production of frozen pulps is an alternative to reduce these losses. To add nutritional and functional benefits to the fruit pulp, it is possible to add soluble fiber, since its high intake is known to have a protective effect against cardiovascular disease and its intake by individuals does not meet the recommended minimum. There is evidence that psyllium dietary fiber contributes to lowering blood pressure, lowering cholesterol, lowering blood glucose and its incorporation into foods may offer health benefits such as preventing high blood pressure. Knowing that sodium and potassium intake is related to blood pressure, this study aimed to investigate the content of the minerals sodium and potassium in frozen banana pulp added with psyllium and to verify the concentrations of bioaccessibility in in vitro digestion. Our results showed that the addition of psyllium contributed to an increase in the content of the minerals potassium and sodium and that after the simulated digestions we verified that the final concentrations of the mineral potassium are in agreement with other results present in the literature, we also saw that despite increasing the sodium content, the final concentration of the dialysate (which would be absorbed by the human body) was 0.17%, being very low and ideal for preventing high blood pressure.

scholarly journals Association between 24-h urinary sodium and potassium excretion and blood pressure among Chinese adults aged 18–69 years

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaofu Du ◽  
Le Fang ◽  
Jianwei Xu ◽  
Xiangyu Chen ◽  
Yamin Bai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Inverse Association ◽  
Potassium Excretion ◽  
Chinese Adults ◽  
Potassium Intake ◽  
Sodium And Potassium

AbstractThe direction and magnitude of the association between sodium and potassium excretion and blood pressure (BP) may differ depending on the characteristics of the study participant or the intake assessment method. Our objective was to assess the relationship between BP, hypertension and 24-h urinary sodium and potassium excretion among Chinese adults. A total of 1424 provincially representative Chinese residents aged 18 to 69 years participated in a cross-sectional survey in 2017 that included demographic data, physical measurements and 24-h urine collection. In this study, the average 24-h urinary sodium and potassium excretion and sodium-to-potassium ratio were 3811.4 mg/day, 1449.3 mg/day, and 4.9, respectively. After multivariable adjustment, each 1000 mg difference in 24-h urinary sodium excretion was significantly associated with systolic BP (0.64 mm Hg; 95% confidence interval [CI] 0.05–1.24) and diastolic BP (0.45 mm Hg; 95% CI 0.08–0.81), and each 1000 mg difference in 24-h urinary potassium excretion was inversely associated with systolic BP (− 3.07 mm Hg; 95% CI − 4.57 to − 1.57) and diastolic BP (− 0.94 mm Hg; 95% CI − 1.87 to − 0.02). The sodium-to-potassium ratio was significantly associated with systolic BP (0.78 mm Hg; 95% CI 0.42–1.13) and diastolic BP (0.31 mm Hg; 95% CI 0.10–0.53) per 1-unit increase. These associations were mainly driven by the hypertensive group. Those with a sodium intake above about 4900 mg/24 h or with a potassium intake below about 1000 mg/24 h had a higher risk of hypertension. At higher but not lower levels of 24-h urinary sodium excretion, potassium can better blunt the sodium-BP relationship. The adjusted odds ratios (ORs) of hypertension in the highest quartile compared with the lowest quartile of excretion were 0.54 (95% CI 0.35–0.84) for potassium and 1.71 (95% CI 1.16–2.51) for the sodium-to-potassium ratio, while the corresponding OR for sodium was not significant (OR, 1.28; 95% CI 0.83–1.98). Our results showed that the sodium intake was significantly associated with BP among hypertensive patients and the inverse association between potassium intake and BP was stronger and involved a larger fraction of the population, especially those with a potassium intake below 1000 mg/24 h should probably increase their potassium intake.

Potassium supplement upregulates the expression of renal kallikrein and bradykinin B2receptor in SHR

1999 ◽  
Vol 276 (3) ◽  
pp. F476-F484 ◽  
Author(s):  
Lan Jin ◽  
Lee Chao ◽  
Julie Chao
Keyword(s):  
Blood Pressure ◽  
Tissue Kallikrein ◽  
Mrna Levels ◽  
High Potassium ◽  
Kinin System ◽  
Glomerular Lesion ◽  
Potassium Supplement ◽  
Potassium Intake ◽  
Renal Kallikrein ◽  
Kallikrein Kinin System

High potassium intake is known to attenuate hypertension, glomerular lesion, ischemic damage, and stroke-associated death. Our recent studies showed that expression of recombinant kallikrein by somatic gene delivery reduced high blood pressure, cardiac hypertrophy, and renal injury in hypertensive animal models. The aim of this study is to explore the potential role of the tissue kallikrein-kinin system in blood pressure reduction and renal protection in spontaneously hypertensive rats (SHR) on a high-potassium diet. Young SHR were given drinking water with or without 1% potassium chloride for 6 wk. Systolic blood pressure was significantly reduced beginning at 1 wk, and the effect lasted for 6 wk in the potassium-supplemented group compared with that in the control group. Potassium supplement induced 70 and 40% increases in urinary kallikrein levels and renal bradykinin B2 receptor density, respectively ( P < 0.05), but did not change serum kininogen levels. Similarly, Northern blot analysis showed that renal kallikrein mRNA levels increased 2.7-fold, whereas hepatic kininogen mRNA levels remained unchanged in rats with high potassium intake. No difference was observed in β-actin mRNA levels in the kidney or liver of either group. Competitive RT-PCR showed a 1.7-fold increase in renal bradykinin B2 receptor mRNA levels in rats with high potassium intake. Potassium supplement significantly increased water intake, urine excretion, urinary kinin, cAMP, and cGMP levels. This study suggests that upregulation of the tissue kallikrein-kinin system may be attributed, in part, to blood pressure-lowering and diuretic effects of high potassium intake.

scholarly journals A Modified Recommended Food Score Is Inversely Associated with High Blood Pressure in Korean Adults

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3479
Author(s):  
Kyuyoung Han ◽  
Yoon Jung Yang ◽  
Hyesook Kim ◽  
Oran Kwon
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Sodium Intake ◽  
Adult Population ◽  
Dietary Intakes ◽  
Lower Prevalence ◽  
Health And Nutrition ◽  
Korean Adult ◽  
Stage 1

Hypertension is associated with an increase in cardiovascular disease and mortality. The interplay between dietary intake—especially sodium intake—and high blood pressure highlights the importance of understanding the role of eating patterns on cardiometabolic risk factors. This study investigates the relationship between a modified version of the Recommended Food Score (RFS) and hypertension in 8389 adults aged 19–64 years from the Korea National Health and Nutrition Examination Survey 2013–2015. A dish-based, semi-quantitative, 112-item food frequency questionnaire was used to assess dietary intakes. Modified RFS (mRFS) is based on the reported consumption of foods recommended in the Dietary Approaches to Stop Hypertension (DASH) diet modified for Korean foods. High blood pressure included hypertension and prehypertension, also known as stage 1 hypertension. Men and women with the highest quintile of mRFS had a 27.2% (OR: 0.728, 95% CI: 0.545–0.971, p-trend = 0.0289) and 32.9% (OR: 0.671, 95% CI: 0.519–0.867, p-trend = 0.0087) lower prevalence of high blood pressure than those with the lowest quintile of mRFS, respectively. Our finding suggests that a higher mRFS may be associated with a lower prevalence of high blood pressure among the Korean adult population.

scholarly journals Dietary Potassium Intake Remains Low and Sodium Intake Remains High, and Most Sodium is Derived from Home Food Preparation for Chinese Adults, 1991–2015 Trends

2020 ◽  
Vol 150 (5) ◽  
pp. 1230-1239 ◽  
Author(s):  
Shufa Du ◽  
Huijun Wang ◽  
Bing Zhang ◽  
Barry M Popkin
Keyword(s):  
Central Region ◽  
Rural Areas ◽  
Sodium Intake ◽  
Food Preparation ◽  
Western World ◽  
Processed Food ◽  
Nutrition Survey ◽  
Random Effects Models ◽  
Potassium Intake ◽  
Most At Risk Populations

ABSTRACT Background Intervention strategies to reduce sodium intake and increase potassium intake may decrease blood pressure; however, most are focused on reducing sodium in processed food globally. Objectives We attempt to fill important gaps in understanding the dynamics of these dietary determinants of hypertension in China. Methods We used data on 29,926 adults aged ≥20 y between 1991 and 2015 from an ongoing cohort, the China Health and Nutrition Survey. We collected detailed diet data with use of weighing methods with 3 consecutive 24-h recalls. With panel data random-effects models, we analyzed factors associated with sodium and potassium intakes and sodium to potassium (Na/K) ratios. Results Sodium intake decreased from 6.3 g/d in 1991 to 4.1 g/d in 2015, still twice the tolerable upper intake recommended by the WHO. Potassium intake was 1.7 g/d in 1991 and 1.5 g/d in 2015, below half that recommended by the WHO. The Na/K ratio decreased from 4.1 (ratios in g) in 1991 to 3.1 in 2015, 5 times the recommendation of the WHO. More than two-thirds (67%) of sodium intake was from salt added during food preparation, with 8.8% from processed foods in 2015, up from 5.0% in 1991. The most at-risk populations lived in China's central region and rural areas, were middle aged, had lower educations, or were farmers. Conclusions Sodium intake is very high across all regions in China. As part of sodium reduction efforts, China should target people living in the central region and adults aged above 60 whose sodium intakes are much higher. Strategies to decrease sodium intake and increase potassium intake should be different from those applied in the Western world where the major source is processed food. Reduced sodium higher potassium salts should become a major policy initiative in China.

scholarly journals Asupan kalium-natrium dan status obesitas sebagai faktor risiko kejadian hipertensi pasien rawat jalan di RS Panembahan Senopati Bantul Yogyakarta

2016 ◽  
Vol 4 (1) ◽  
pp. 41
Author(s):  
Effatul Afifah
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Food Frequency Questionnaire ◽  
Sodium Intake ◽  
T Test ◽  
Research Association ◽  
Chi Square ◽  
Sodium Potassium ◽  
Food Frequency ◽  
Potassium Intake

<p><strong>ABSTRACT</strong></p><p><em><strong>Background</strong>: Hypertension is one of the problems in the medical and public health area. Based on National Health Research Association in 2013, hypertension is the third leading cause of death of all ages patterns, after stroke and TB, with the proportion of deaths was 6.8%. The prevalence of hypertension in DIY was 25.7%. The risk factors of diet containing high fat, high sodium, and low potassium to elevate blood pressure.</em></p><p><em><strong>Objectives</strong>: To know the effect of the intake of sodium-potassium and the status of obesity as a risk factor for hypertension.</em></p><p><em><strong>Methods</strong>: This study used analytic observational study design with control-case design. Samples were 104 and divided into 52 cases and 52 controls. Data were collected using a questionnaire include: name, age, gender, address, education level, the type of work, and form of food frequency questionnaire (FFQ) to inquire patterns of food intake (intake of sodium-potassium) for 3 months with food models. Obesity status was measured using body mass index (BMI), and merqurial sphygmomanometer hypertension was</em><br /><em>used to measure blood pressure. Analysis of data used statistical test independent t-test, chi-square.</em></p><p><em><strong>Results</strong>: No significant correlation between age and the incidence of hypertension (OR=2.448), neither did sodium intake with hypertension, potassium intake with hypertension, and nutritional status (obesity) associated with the incidence of hypertension.</em></p><p><em><strong>Conclusions</strong>: Age was the risk factor for hypertension, while the intake of sodium-potassium and status of obesity were not.</em></p><p><strong>KEYWORDS</strong>:<em> hypertension, sodium intake, potassium intake, obesity</em></p><p><br /><strong>ABSTRAK</strong></p><p><em><strong>Latar belakang</strong>: Hipertensi merupakan salah satu masalah dalam dunia medis dan kesehatan masyarakat. Dalam riset kesehatan dasar nasional tahun 2013, hipertensi merupakan penyebab kematian semua umur yang ketiga, setelah stroke dan tuberculosis (TB), dengan proporsi kematian sebesar 6,8%. Prevalensi hipertensi untuk wilayah DIY 25,7% termasuk angka yang tinggi. Faktor risiko pola makan yang mengandung tinggi lemak, tinggi natrium dan rendah kalium memiliki kontribusi terhadap peningkatan</em><br /><em>tekanan darah.</em></p><p><em><strong>Tujuan</strong>: Untuk mengetahui pengaruh asupan natrium, kalium, dan status obesitas sebagai faktor risiko hipertensi.</em></p><p><em><strong>Metode</strong>: Penelitian ini menggunakan desain studi observasional analitik dengan rancangan kasus kontrol dengan jumlah total sampel 104 yang terbagi dalam 52 kasus dan 52 kontrol. Pengumpulan data menggunakan kuesioner meliputi: nama, umur, jenis kelamin, alamat, tingkat pendidikan, dan jenis pekerjaan dan formulir food frequency questionnaire (FFQ) untuk menanyakan pola asupan makanan (asupan natrium, kalium) selama 3 bulan menggunakan food model. Status obesitas diukur dengan menggunakan indek massa tubuh (IMT) dan hipertensi diukur menggunakan merqurial sphygmomanometer. Analisis data menggunakan uji statistik independent t-test, chi-square.</em></p><p><em><strong>Hasil</strong>: Ada hubungan yang signifikan antara usia dengan kejadian hipertensi (OR=2,448). Asupan natrium tidak berhubungan signifi kan dengan hipertensi. Tidak ada hubungan yang signifikan antara asupan kalium dengan hipertensi dan status gizi (obesitas) tidak berhubungan secara signifikan dengan kejadian hipertensi.</em></p><p><em><strong>Kesimpulan</strong>: Usia merupakan faktor risiko kejadian hipertensi, sedangkan asupan natrium, kalium, dan status obesitas bukan merupakan faktor risiko hipertensi.</em></p><p><strong>KATA KUNCI</strong><em>: hipertensi, asupan natrium, asupan kalium, obesitas</em></p>

scholarly journals KARAKTERISTIK INDEKS MASSA TUBUH DAN JENIS KELAMIN PASIEN HIPERTENSI DI RS IBNU SINA MAKASSAR NOVEMBER 2018

2021 ◽  
Vol 7 (2) ◽  
pp. 64
Author(s):  
Rachmat Faisal Syamsu ◽  
Siska Nuryanti ◽  
Muhammad Yastrib Semme
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Nutritional Status ◽  
High Blood Pressure ◽  
Sodium Intake ◽  
Sampling Technique ◽  
The Body ◽  
Number Of Patients ◽  
High Prevalence ◽  
Male Patients

Hypertension, commonly referred to as high blood pressure, is a global health problem in Indonesia because of its high prevalence, although it varies in different countries. In Indonesia, hypertension is found in 83 per 1000 household members. The majority of high blood pressure increases with the presence of risk factors such as; Age, lack of exercise / physical activity, genetic factors and family history, body weight/obesity, sodium intake, alcohol consumption, smoking, stress. This study is a descriptive design using an observational approach to describe the characteristics of the risk factors for the Body Mass Index (BMI) and the gender of hypertension patients at Ibnu Sina Hospital for November 2018. The sampling technique used the total sampling technique with a complete sample size of 26 people. The results showed that the gender characteristics of hypertension sufferers showed that the number of female patients (16 people) was more than that of male patients (10 people). And the attributes of BMI in patients with hypertension found that the number of patients with normal nutritional status (13 people) was the most compared to another nutritional status.

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