Short-Term RCT of Increased Dietary Potassium from Potato or Potassium Gluconate: Effect on Blood Pressure, Microcirculation, and Potassium and Sodium Retention in Pre-Hypertensive-to-Hypertensive Adults

Increased potassium intake has been linked to improvements in cardiovascular and other health outcomes. We assessed increasing potassium intake through food or supplements as part of a controlled diet on blood pressure (BP), microcirculation (endothelial function), and potassium and sodium retention in thirty pre-hypertensive-to-hypertensive men and women. Participants were randomly assigned to a sequence of four 17 day dietary potassium treatments: a basal diet (control) of 60 mmol/d and three phases of 85 mmol/d added as potatoes, French fries, or a potassium gluconate supplement. Blood pressure was measured by manual auscultation, cutaneous microvascular and endothelial function by thermal hyperemia, utilizing laser Doppler flowmetry, and mineral retention by metabolic balance. There were no significant differences among treatments for end-of-treatment BP, change in BP over time, or endothelial function using a mixed-model ANOVA. However, there was a greater change in systolic blood pressure (SBP) over time by feeding baked/boiled potatoes compared with control (−6.0 mmHg vs. −2.6 mmHg; p = 0.011) using contrast analysis. Potassium retention was highest with supplements. Individuals with a higher cardiometabolic risk may benefit by increasing potassium intake. This trial was registered at ClinicalTrials.gov as NCT02697708.

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Short-Term Supplemental Dietary Potassium from Potato and Potassium Gluconate: Effect on Calcium Retention and Urinary pH in Pre-Hypertensive-to-Hypertensive Adults

Nutrients ◽

10.3390/nu13124399 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4399

Author(s):

Michael S. Stone ◽

Berdine R. Martin ◽

Connie M. Weaver

Keyword(s):

Mixed Model ◽

Basal Diet ◽

Pressure Effects ◽

Urine Ph ◽

Urinary Ph ◽

Potassium Supplement ◽

Potassium Intake ◽

Dietary Potassium ◽

Significant Difference ◽

The Impact

Potassium supplementation has been associated with reduced urinary calcium (Ca) excretion and increased Ca balance. Dietary interventions assessing the impact of potassium on bone are lacking. In this secondary analysis of a study designed primarily to determine blood pressure effects, we assessed the effects of potassium intake from potato sources and a potassium supplement on urinary Ca, urine pH, and Ca balance. Thirty men (n = 15) and women (n = 15) with a mean ± SD age and BMI of 48.2 ± 15 years and 31.4 ± 6.1 kg/m2, respectively, were enrolled in a cross-over, randomized control feeding trial. Participants were assigned to a random order of four 16-day dietary potassium interventions including a basal diet (control) of 2300 mg/day (~60 mmol/day) of potassium, and three phases of an additional 1000 mg/day (3300 mg/day(~85 mmol/day) total) of potassium in the form of potatoes (baked, boiled, or pan-heated), French fries (FF), or a potassium (K)-gluconate supplement. Calcium intake for all diets was approximately 700–800 mg/day. Using a mixed model ANOVA there was a significantly lower urinary Ca excretion in the K-gluconate phase (96 ± 10 mg/day) compared to the control (115 ± 10 mg/day; p = 0.027) and potato (114 ± 10 mg/day; p = 0.033). In addition, there was a significant difference in urinary pH between the supplement and control phases (6.54 ± 0.16 vs. 6.08 ± 0.18; p = 0.0036). There were no significant differences in Ca retention. An increased potassium intake via K-gluconate supplementation may favorably influence urinary Ca excretion and urine pH. This trial was registered at ClinicalTrials.gov as NCT02697708.

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Abstract P091: Short-term Increased Dietary Potassium From Potato and Potassium Gluconate Has No Effect on Blood Pressure and Microcirculation in Pre-hypertensive-to-hypertensive Adults

Circulation ◽

10.1161/circ.139.suppl_1.p091 ◽

2019 ◽

Vol 139 (Suppl_1) ◽

Author(s):

Michael S Stone ◽

Berdine R Martin ◽

George P McCabe ◽

Linda D McCabe ◽

Connie M Weaver

Keyword(s):

Blood Pressure ◽

Short Term ◽

Potassium Gluconate ◽

Dietary Potassium

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MMPs and TIMPs levels are correlated with anthropometric parameters, blood pressure, and endothelial function in obesity

Scientific Reports ◽

10.1038/s41598-021-99577-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Soumaya Boumiza ◽

Karim Chahed ◽

Zouhair Tabka ◽

Marie-Paule Jacob ◽

Xavier Norel ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Endothelial Function ◽

Biochemical Parameters ◽

Anthropometric Parameters ◽

Obese People ◽

Doppler Flowmetry ◽

Related Disease ◽

Clinical Biomarkers ◽

Obese Subjects

AbstractThe association between matrix metalloproteinases (MMPs), tissue inhibitor of metalloproteinases (TIMPs) and obesity as well as obesity-related disease including metabolic syndrome is not fully explored. Our aims are that: (i) to evaluate the plasma levels of MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1, TIMP-2 and their ratios in non-obese people, overweight and obese people with or without metabolic syndrome, (ii) to investigate correlations between MMPs or TIMPs levels and several anthropometric parameters, blood pressure, endothelial function. Anthropometric and biochemical parameters were determined in 479 randomly selected participants, subdividing according to body mass index (BMI) and metabolic syndrome status. Plasma MMPs and TIMPs levels were measured. The assessment of endothelial function was characterized in people with obesity, overweight and non-obese, using laser Doppler Flowmetry. Obese people have elevated MMP-1, MMP-2, TIMP-1, TIMP-2 levels and decreased MMP-3/TIMP-1 and MMP-9/TIMP-1 ratios compared with non-obese people. MMP-1 levels and MMP-1/TIMP-1 ratio were positively correlated with BMI and waist circumference (WC) while MMP-2 levels were negatively correlated with BMI and WC values in obese people. MMP-3 levels and MMP-3/TIMP-1 ratio were positively correlated with systolic blood pressure (SBP) or diastolic blood pressure (DBP) in obese and metabolic syndrome people. Additionally, MMP-9 levels and MMP-9/TIMP-1 ratio were negatively correlated with endothelium-dependent response in obese and metabolic syndrome people. MMP-1, MMP-2, TIMP-1, TIMP-2 levels were increased in obese subjects. Significant correlations between anthropometric parameters and MMP-1 as well as MMP-1/TIMP-1 ratio supported these results. MMP-3 and -9 levels as well as their ratios with TIMP-1 were associated with blood pressure and endothelial-dependent response, respectively. In conclusion, our results demonstrated that MMP-1, MMP-3 and MMP-9 levels were correlated with several obesity-related parameters including BMI, WC, blood pressure and endothelial-dependent response. Our findings will hopefully provide new aspects for the use of MMPs and TIMPs as clinical biomarkers in obesity-related cardiovascular diseases such as metabolic syndrome and hypertension. The lack of measure of MMPs activity in plasma and relevant organs/tissues in obesity and metabolic syndrome is considered as a limitation in this report.

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No Evidence of Racial Disparities in Blood Pressure Salt Sensitivity When Potassium Intake Exceeds Levels Recommended in the US Dietary Guidelines

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00980.2020 ◽

2021 ◽

Author(s):

Theodore W. Kurtz ◽

Stephen E. DiCarlo ◽

Michal Pravenec ◽

R. Curtis Morris

Keyword(s):

Blood Pressure ◽

Racial Disparities ◽

Racial Differences ◽

Salt Intake ◽

Salt Sensitivity ◽

Dietary Guidelines ◽

Potassium Intake ◽

Dietary Potassium ◽

The Us ◽

The Impact

On average, black individuals are widely believed to be more sensitive than white individuals to blood pressure (BP) effects of changes in salt intake. However, few studies have directly compared the BP effects of changing salt intake in black versus white individuals. In this narrative review, we analyze those studies and note that when potassium intake substantially exceeds the recently recommended US dietary goal of 87 mmol/d, black adults do not appear more sensitive than white adults to BP effects of short-term or long-term increases in salt intake (from an intake ≤ 50 mmol/d up to 150 mmol/d or more). However, with lower potassium intakes, racial differences in salt sensitivity are observed. Mechanistic studies suggest that racial differences in salt sensitivity are related to differences in vascular resistance responses to changes in salt intake mediated by vasodilator and vasoconstrictor pathways. With respect to cause and prevention of racial disparities in salt sensitivity, it is noteworthy that 1) on average, black individuals consume less potassium than white individuals and 2) consuming supplemental potassium bicarbonate, or potassium rich foods can prevent racial disparities in salt-sensitivity. However, the new US Dietary Guidelines reduced the dietary potassium goal well-below the amount associated with preventing racial disparities in salt sensitivity. These observations should motivate research on the impact of the new dietary potassium guidelines on racial disparities in salt sensitivity, the risks and benefits of potassium-containing salt substitutes or supplements, and methods for increasing consumption of foods rich in nutrients that protect against salt-induced hypertension.

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Evidence of an Inverse Relationship Between Dietary Potassium Intake and Blood Pressure

Basic Science for the Cardiologist - Role of Potassium in Preventive Cardiovascular Medicine ◽

10.1007/978-1-4615-1443-5_9 ◽

2001 ◽

pp. 123-154

Author(s):

David B. Young

Keyword(s):

Blood Pressure ◽

Inverse Relationship ◽

Potassium Intake ◽

Dietary Potassium

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Association of Urinary Potassium Excretion with Blood Pressure Variability and Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Nutrients ◽

10.3390/nu13124443 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4443

Author(s):

Sang Heon Suh ◽

Su Hyun Song ◽

Tae Ryom Oh ◽

Hong Sang Choi ◽

Chang Seong Kim ◽

...

Keyword(s):

Blood Pressure ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Blood Pressure Variability ◽

Potassium Excretion ◽

Regression Analyses ◽

Potassium Intake ◽

Increased Risk ◽

Dietary Potassium ◽

Urine Potassium

Dietary potassium intake is a dilemma in patients with chronic kidney disease (CKD). We investigated the association of urine potassium excretion, a surrogate for dietary potassium intake, with blood pressure variability (BPV) and cardiovascular (CV) outcomes in patients with pre-dialysis CKD. A total of 1860 participants from a cohort of pre-dialysis CKD (KNOW-CKD) patients were divided into the quartiles by spot urine potassium-to-creatinine ratio. The first quartile (26.423 ± 5.731 mmol/gCr) was defined as low urine potassium excretion. Multivariate linear regression analyses revealed an independent association of low urine potassium excretion with high BPV (adjusted β coefficient 1.163, 95% confidence interval 0.424 to 1.901). Cox regression analyses demonstrated that, compared to high urine potassium excretion, low urine potassium excretion is associated with increased risk of CV events (adjusted hazard ratio 2.502, 95% confidence interval 1.162 to 5.387) but not with all-cause mortality. In conclusion, low urine potassium excretion is associated with high BPV and increased risk of CV events in patients with pre-dialysis CKD. The restriction of dietary potassium intake should be individualized in patients with pre-dialysis CKD.

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Low dietary potassium intake stimulates NCC to cause sodium retention (892.16)

The FASEB Journal ◽

10.1096/fasebj.28.1_supplement.892.16 ◽

2014 ◽

Vol 28 (S1) ◽

Author(s):

Andrew Terker ◽

Chao‐Ling Yang ◽

David Ellison

Keyword(s):

Sodium Retention ◽

Potassium Intake ◽

Dietary Potassium

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Abstract P175: Systolic Blood Pressure Trajectory Across Childhood to Adolescence Predicts Self-reported Htn in Adults: I3c CV Outcomes Study

Circulation ◽

10.1161/circ.141.suppl_1.p175 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Elaine M Urbina ◽

Philip R Khoury ◽

Tian Hu ◽

Lydia A Bazzano ◽

Trudy Burns ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Mixed Model ◽

Logistic Models ◽

Odds Ratios ◽

Random Intercept ◽

Outcomes Study ◽

Trajectory Group ◽

The Right ◽

Over Time

Levels of systolic blood pressure (SBP) in youth tend to predict adult SBP levels, but whether the trajectory of SBP over time predicts adult HTN is not known. In the International Childhood CV Cohort (i3C) Consortium, we constructed SBP trajectories in 9515 participants who had ≥2 SBPs in youth, and who reported HTN status (by questionnaire) at mean age 47 years. We used measured SBP from age 3-19 years to form trajectories using a mixed model with spline for age and random intercept and slope. The intercept and slope form personal trajectories during age 3-19 after removing the overall curve (spline) common to all participants. Trajectory groupings were formed by stratifying the intercept and slope by tertiles, forming 9 nearly equal sized groups, each having a consistent intercept and slope combination, among either a low, mid or high intercept and low (declining), mid (flat) or high (increasing) slope. The average SBP for all measurements in 6 age categories characterized the trajectories (Figure left panel). This characterization is reiterated using ages 3-11 and 12-19 years in the right panel which displays the adult HTN prevalence across the trajectories. Logistic models evaluated whether SBP trajectory group predicted adult HTN after adjustment for age and year at first childhood SBP measurement, age and BMI at adult HTN, smoking, sex, cohort, and race. Overall adult HTN prevalence was 30.9% increasing across SBP trajectories. All SBP trajectories compared to the highest intercept/slope group remained significant predictors of adult HTN even after adjustments (odds ratios 0.24 for lowest intercept/slope trajectory and 0.75 for highest intercept/intermediate slope trajectory both compared to highest intercept/highest slope, all P<0.0001). We conclude that baseline (intercept) and slope of SBP changes from childhood to adolescence can assist providers in identifying potential for modifying the development of hypertension in adulthood.

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