Potassium

Potassium-Rich Foods May Boost Women’s Heart Health, Study Says

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Every gram of potassium consumed can lower systolic blood pressure by 2.4 mmHg.

preview for 5 Ways to Keep Your Heart Healthy
  • A new study found eating a potassium-rich diet may improve heart health, specifically for women with high sodium intake.
  • Researchers found for every gram of potassium consumed daily, systolic blood pressure was lowered by 2.4 mmHg.
  • Experts suggest incorporating more potassium-rich foods into your diet, like bananas, potatoes, beans, and spinach.

Researchers have known for a while that a diet high in potassium can help lower blood pressure and risk for cardiovascular disease, but a new study published in the European Heart Journal found that a potassium-rich diet can specifically help women improve their heart health.

The new study determined that the more grams of potassium consumed per day, the more the blood pressure of women who consumed high amounts of sodium improved. In fact, scientists found that for each additional gram of potassium consumed daily, systolic blood pressure was lowered by 2.4 mmHg. In short: as potassium levels went up in the diet, sodium levels went down in the blood.

The research examined how potassium impacted the blood pressure of nearly 25,000 participants. Of those in the study, about 55% were women and 45% were men and their data came from the European Prospective Investigation into Cancer-Norfolk study. Participants were from the United Kingdom and between the ages of 40 to 79 years old from 1993 to 1997.

Participants filled out a lifestyle questionnaire and had their blood pressure taken and urine sampled by researchers. Urine samples were examined for sodium and potassium levels. But the benefits weren’t just seen in women. Researchers followed up with participants after a median of 20 years and found that women who had the highest intake of potassium had an 11% lower risk of hospitalization or death due to cardiovascular disease and men lowered their risk by 7% compared to those with the lowest potassium intake.

What experts have to say

Howard Weintraub, M.D., cardiologist and clinical director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Health says that the idea of potassium lowering the risk for cardiovascular disease and improving heart health and blood pressure isn’t anything new. What makes this study so impressive is that it included a huge cohort and they found a very significant change through their data, especially in women, he says.

Dr. Weintraub notes that the main limitation in this study, which the authors recognize, is that only one urine sample was collected per participant. He notes that sodium and potassium in the urine can fluctuate. For example, if you ate a plant-based meal with very limited salt versus a takeout hamburger with salty fries, it can impact the total amount of sodium and potassium in your urine.

But the main question experts still have is—why women? The study found the strongest association between lowering blood pressure and an increase in potassium intake for women who consumed high amounts of sodium. They did not find the same for men, and experts are still scratching their heads.

“It’s thought-provoking and hypothesis-provoking, but the fact that it has this unusual, more restricted relationship raises questions in my mind,” Dr. Weintraub says. He notes that the study authors offer a few ideas as to why this is, but the bottom line is that they don’t really know.

In the study, experts reference research done on rats where the female sex hormone (estrogen) likely played a part in the role of potassium in their overall health. But, studies on rats don’t always equate to human circumstances, Dr. Weintraub says. Additionally, the researchers note that many of the women involved in the study were postmenopausal, so other mechanisms may be playing a role in this case.

The bottom line

Cardiovascular disease is the leading cause of death worldwide, causing one in four deaths in men and one in five deaths in women in the United States, according to the Centers for Disease Control and Prevention. Risk factors for cardiovascular disease are high blood pressure, high cholesterol, and smoking. Additionally, many experts point to a diet high in sodium and processed foods as risk factors for cardiovascular disease.

This particular study suggests that eating more potassium can help the kidneys get rid of sodium in the blood, which can help blood pressure go down. If you can maintain lower blood pressure long-term, there can be a change in cardiovascular risk, Dr. Weintraub says.

“As a prevention specialist in the cardiovascular arena, we’ve always talked about limiting sodium intake, that has been an unambiguous issue,” he says. “The diet we encourage is the Mediterranean diet, which has been shown to save lives.”

If you’re looking for ways to lower your blood pressure naturally, it’s important to talk to your healthcare provider about the possible causes of your high blood pressure to create a plan that works for you. A diet that incorporates foods that help lower blood pressure naturally, can be key in realizing your target numbers.

Research has shown eating a wider variety of proteins may lower the risk of high blood pressure. Additionally, high-potassium foods can be an integral part of your diet plan, like white and sweet potatoes, bananas, beets, spinach, beans, and avocado.

Lastly, Dr. Weintraub warns to be cautious of consuming too much potassium in your diet, because it can impact kidney function and become very dangerous.

So, it’s important to consult your doctor before drastically increasing your potassium intake. And, these findings mean that adding a bit more into your routine could prove beneficial to heart health.

How a potassium-based quality-of-service metric reduces phlebotomy errors

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Preanalytical errors in laboratory testing are a frequent cause of inaccurate clinical lab results and can occur at any time—from test ordering, to sample collection, to specimen transport and handling. Data about preanalytical errors are often collected, and monitoring helps identify areas in which such errors are more likely to occur. Preanalytical errors often occur during sample-collection steps and can involve tourniquet time, tube type, order of draw, and filling, mixing, and transporting specimens to prevent hemolysis. If performed incorrectly, these process steps can cause changes in concentrations of critical serum and plasma analytes, including potassium. Because true hyperkalemia is a life-threatening panic value, it is important to address phlebotomy steps that may lead to spurious potassium results. The authors described herein the institutionwide implementation of a continuous quality management program focused on a potassium phlebotomy metric that supports continuous feedback, intervention, and retraining. This quality-of-service phlebotomy metric involves systematically evaluating plasma potassium concentrations per phlebotomist to detect preanalytical biases caused by variations in sample collection and handling that do not lead to frank hemolysis. The authors monitored potassium and retrained 26 full-time phlebotomists as part of their quality-of-service intervention pilot program. They periodically downloaded potassium values, measured between January 2013 and December 2020, from the electronic health record system. The name of the person performing the phlebotomy and the collection location, time, and date were recorded. The potassium threshold selected for hyperkalemia was more than 5.2 mmol/L and for hypokalemia was up to 3.5 mmol/L. The authors assessed how variations in potassium concentrations affected resource utilization. Laboratory-associated costs were calculated based on turnaround time, processing/procedure-related times and expenses, and the average hourly salaries of lab personnel, including phlebotomists. The authors developed an algorithm for monitoring data and providing feedback on a per phlebotomist basis. Their project was divided into three phases: Phase one involved investigating phlebotomy techniques and procedures; phase two involved implementing monthly surveillance on a per phlebotomist basis and monitoring potassium values for their effects on resource utilization; and phase three involved institutionwide use of the aforementioned quality-of-service metric. The results showed that intervention and retraining reinforced compliance with phlebotomy techniques and reduced the percentage of venipunctures with potassium results above the threshold. This resulted in an average savings of 13 to 100 percent for each high-volume phlebotomist and reduced the number of repeat blood draws needed to confirm hyperkalemia. Supervisors initially met with each phlebotomist monthly to review the data but, eventually, met only with those who had more than two percent of draws with potassium values above the 5.2 mmol/L threshold, to help reinforce compliance with techniques. The authors concluded that the ability to provide feedback and retraining on a per phlebotomist basis reduced erroneous hyperkalemia events and critical value alerts and led to significant cost savings. The simplicity and impact of this quality-of-service metric may help reduce preanalytical errors from phlebotomy techniques at other institutions as well.

Adding daily potassium may improve heart health in women with high-sodium diet

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In women with a high-sodium diet, every 1 g increase in daily potassium intake was associated with a 2.4 mm Hg lower systolic BP, according to data from a large cohort study.

In an analysis of long-term cohort data, researchers also found that women within the highest tertile of potassium intake had an 11% lower risk for incident and/or recurrent CVD events during nearly 20 years of follow-up compared with women with the lowest tertile of potassium intake, with a smaller but still significant CVD benefit observed for men.

Graphical depiction of data presented in article
Data were derived from Wouda RD, et al. Eur Heart J. 2022;doi:10.1093/eurheartj/ehac313.

“Most dietary advice is focused on sodium excess, yet we tend to ignore potassium,” Liffert Vogt, MD, PhD, an internist-nephrologist and full professor in nephrology at Amsterdam UMC and the University of Amsterdam, told Healio. “Our study shows that high daily potassium consumption might have a protective effect in terms of CV risk and mortality in a population with a very high background of sodium consumption. In light of the difficulties providers face in clinical practice restricting elements like sodium, calorie intake and saturated fats in the diet, adding or increasing intake of a healthy food ingredient like potassium might be very effective in reducing health risks.”

Liffert Vogt

Vogt and colleagues analyzed data from 11,267 men and 13,696 women participating in the Norfolk cohort of the European Prospective Investigation into Cancer (EPIC-Norfolk) study, a prospective, population-based cohort study (mean age of men, 60 years; mean age of women, 59 years). Researchers collected spot urine samples to estimate 24-hour excretion of sodium and potassium, reflecting intake, and assessed the association between potassium intake, systolic BP and CVD events, defined as hospitalization or death due to CVD.

Interaction between potassium intake, BP

Within the cohort, 18.5% of men and 18.6% of women used antihypertensive medications. For men, estimated potassium intake was 2.8 g per day and estimated sodium intake was 4.9 g per day. For women estimated potassium intake was 2.6 g per day and estimated sodium intake was 4.2 g per day. The median spot urine sodium-to-potassium concentration was 1.7 in men and 1.5 in women.

Researchers found potassium intake was associated with systolic BP after adjustments for age, sex and sodium intake (P < .001), with significant interaction by sex (P < .001).

In women only, researchers observed an interaction by sodium intake (highest vs. lowest tertile) for the association between potassium intake and systolic BP (P < .001). In analyses stratified by sodium intake, an inverse association between potassium intake and systolic BP persisted only for those in the highest tertile of sodium intake (P < .001).

“In women within the highest tertile of sodium intake, every 1 g increase in daily potassium intake was associated with a 2.4 mm Hg lower systolic BP,” the researchers wrote.

Diet and long-term CV outcomes

During a median follow-up of 19.5 years, CVD events occurred in 54.5% of participants, including in 59.5% of men and 50.3% of women. For both men and women, a higher potassium intake was associated with lower risk for CVD events. In the overall cohort, the HR for CVD events in the highest tertile of potassium intake compared with the lowest was 0.87 (95% CI, 0.82-0.93). However, the HR associated with higher potassium intake was lower for women (HR = 0.89; 95% CI, 0.83-0.95) vs. men (HR = 0.93; 95% CI, 0.87-1; P for interaction by sex = .033).

For men and women, the association between potassium intake and CVD events was not modified by sodium intake.

“Potassium intake deserves more attention,” Vogt told Healio. “High potassium intake is a good marker for the amounts of healthy foods an individual consumes on a daily basis, including vegetables, legumes, fruits, nuts, dairy products and fish. Therefore, focusing on a varied diet rich in potassium, instead of solely providing advice with regard to sodium intake, is an easy step to implement.”

Vogt noted that the findings may apply more to women vs. men.

“In women, high potassium consumption is associated with a low BP and this effect seems to be the driving factor behind less CV problems on the long run,” Vogt said. “A new and surprising finding is that we did not observe any association between potassium and BP in men. In women, the effect of high potassium consumption was the largest in women that had the highest daily sodium consumption.

“Our study cannot claim any causal links; for this, we need a randomized controlled study,” Vogt told Healio. “We are currently conducting such a study in the Netherlands with people with chronic kidney disease. We also need more research on whether potassium alone, or the other healthy ingredients associated with a high-potassium diet, explain the beneficial effects that we found.”

Does Potassium Lower Blood Pressure?

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It’s not groundbreaking news that high blood pressure and diet are related. Even when you go the medical doctor route, one of the first things your doctor will suggest is lowering your salt intake to help control your blood pressure. But what else can help? Does potassium lower blood pressure? Often, one important nutritional catalyst is overlooked; and yes, it is indeed potassium.

bananaeaten 235x147 Does Potassium Lower Blood Pressure?

Does Potassium Lower Blood Pressure?

Potassium has several functions in the body, aiding with the proper workings of the heart, kidneys, nerves, muscles and the digestive system. A lack of potassium can manifest itself in many ways, including high blood pressure.

Researchers have looked at the connection between high blood pressure and potassium for decades, determining that simply increasing your potassium intake while lowering your sodium intake is enough to get your blood pressure back under control.

Our friends over at NaturalNews have compiled some pretty telling statements from experts in the medical and nutritional community on the power of potassium in helping control blood pressure.

Sodium and potassium play related role in controlling fluid balance in the body. Without sufficient potassium to help the body secrete sodium, sodium builds up and exerts its harmful effects. Thus, to reduce high blood pressure most people need not only to lower sodium intake but also to increase potassium consumption. Indeed, some studies indicate that potassium intake is a stronger factor in determining blood pressure than is sodium intake. Various population studies confirm a beneficial effect on blood pressure from increases in potassium consumption.

– Off-the-Shelf Natural Health by Mark Mayell

The sudden death that can occur in fasting, anorexia nervosa, or starvation is often a result of heart failure caused by potassium deficiency. Many population studies have found links between low potassium intakes and an increased risk of high blood pressure and death from stroke. Increasing the amount of potassium-rich foods in the diet can lead to a reduction in high blood pressure. The ratio of sodium to potassium in the diet appears to play an important role in the development of high blood pressure. The typical Western diet is low in potassium relative to sodium.

– The New Encyclopedia of Vitamins, Minerals, Supplements and Herbs by Nicola Reavley

One study conducted from St. George’s Medical School in London and published in the April 2005 issue of Hypertension, found that potassium citrate can lower blood pressure just as well as potassium chloride – which has been shown to lower blood pressure. Potassium chloride must be taken in supplement form, while potassium citrate can be attained through foods.


After comparing the blood-pressure-lowering effects of potassium chloride against the effects of potassium citrate, researchers found that each one has similarly positive effects. Adults starting at 151/93 on average found their blood pressure reduced to 140/88 while using potassium chloride, and 138/88 when taking potassium citrate.

Potassium Food Sources

Sure, you could take a potassium supplement. But, why pop a pill when you can get plenty of potassium through healthy food choices. You can get about the same potassium from one bite of a banana as you can from one 99 mg supplement. The following foods are rich in potassium. By cutting down on sodium and eating several of these foods each day, you can combat high blood pressure naturally:

 

 

Higher Potassium Intake Lowers Blood Pressure and Is Associated with Less Risk for Stroke.

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A BP-lowering effect was noted in hypertensive people and those with high sodium intake.

Low potassium intake is associated with hypertension and stroke. In new meta-analyses, investigators assessed whether higher potassium intake protects against hypertension and adverse cardiovascular (CV) events, including stroke.

Overall, 1600 individuals participated in 22 randomized trials; trial interventions were provision of potassium supplements in 20 trials and dietary advice in the other 2. Higher potassium consumption significantly reduced systolic blood pressure (SBP) by a mean 5.9 mm Hg and diastolic blood pressure (DBP) by a mean 3.8 mm Hg. However, subgroup analyses revealed that higher potassium intake lowered BP only in patients with hypertension (i.e., not in patients with normal or low BP). Daily potassium intake of 90 to 120 mmol was associated with the largest reductions in SBP (mean, 7.2 mm Hg) and DBP (mean, 4.0 mm Hg). Notably, higher potassium intake lowered SBP regardless of baseline potassium intake and antihypertensive drug use. When trials were grouped by participants’ sodium intake, the greatest decrease in SBP (mean, 6.9 mm Hg) was seen in studies with the highest daily mean sodium intake (>4 g). In 11 cohort studies that involved 127,000 patients, high potassium intake was associated with less risk for stroke (risk ratio, 0.76) but not with lower risk for incident CV disease or coronary heart disease.

Comment: In these meta-analyses, higher potassium intake lowered SBP and DBP and was associated with less stroke risk. Patients, especially those with hypertension, should be advised to not only reduce their sodium intake but also to increase their potassium intake.

 

Source: Journal Watch General Medicine

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

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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.

Source: BMJ

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

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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.

Source: BMJ