title: Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses.
abstract: OBJECTIVE
  To conduct a systematic review of the literature and meta-analyses to fill the gaps in knowledge on potassium intake and health.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Nutrition Policy and Scientific Advice Unit, Department of Nutrition for Health and Development, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. nancy.aburto@wfp.org
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Aburto
authors.forename: Sara
authors.initials: S
authors.lastname: Hanson
authors.forename: Hialy
authors.initials: H
authors.lastname: Gutierrez
authors.forename: Lee
authors.initials: L
authors.lastname: Hooper
authors.forename: Paul
authors.initials: P
authors.lastname: Elliott
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Cappuccio
mesh_terms: D001794:Blood Pressure; D002395:Catecholamines / Q000378:metabolism; D003327:Coronary Disease / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control*; D050356:Lipid Metabolism; D008297:Male; D017419:Potassium, Dietary / Q000008:administration & dosage* / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D020521:Stroke / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control*
chemical_list: D002395:Catecholamines; D017419:Potassium, Dietary
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