title: Daily potassium intake and sodium-to-potassium ratio in the reduction of blood pressure: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To evaluate the efficacy of daily potassium intake on decreasing blood pressure in non-medicated normotensive or hypertensive patients, and to determine the relationship between potassium intake, sodium-to-potassium ratio and reduction in blood pressure.
  
  
  METHODS
  Mixed-effect meta-analyses and meta-regression models.
  
  
  METHODS
  Medline and the references of previous meta-analyses.
  
  
  METHODS
  Randomized controlled trials with potassium supplementation, with blood pressure as the primary outcome, in non-medicated patients.
  
  
  RESULTS
  Fifteen randomized controlled trials of potassium supplementation in patients without antihypertensive medication were selected for the meta-analyses (917 patients). Potassium supplementation resulted in reduction of SBP by 4.7 mmHg [95% confidence interval (CI) 2.4-7.0] and DBP by 3.5 mmHg (95% CI 1.3-5.7) in all patients. The effect was found to be greater in hypertensive patients, with a reduction of SBP by 6.8 mmHg (95% CI 4.3-9.3) and DBP by 4.6 mmHg (95% CI 1.8-7.5). Meta-regression analysis showed that both increased daily potassium excretion and decreased sodium-to-potassium ratio were associated with blood pressure reduction (P < 0.05). Increased total daily potassium urinary excretion from 60 to 100 mmol/day and decrease of sodium-to-potassium ratio were shown to be necessary to explain the estimated effect.
  
  
  CONCLUSIONS
  Potassium supplementation is associated with reduction of blood pressure in patients who are not on antihypertensive medication, and the effect is significant in hypertensive patients. The reduction in blood pressure significantly correlates with decreased daily urinary sodium-to-potassium ratio and increased urinary potassium. Patients with elevated blood pressure may benefit from increased potassium intake along with controlled or decreased sodium intake.
authors.affiliation: aNutrition & Health Research bClinical Development Unit cPublic Health Nutrition, Nestlé Research Centre, Lausanne, Switzerland.
authors.forename: Aristea
authors.initials: A
authors.lastname: Binia
authors.forename: Jonathan
authors.initials: J
authors.lastname: Jaeger
authors.forename: Youyou
authors.initials: Y
authors.lastname: Hu
authors.forename: Anurag
authors.initials: A
authors.lastname: Singh
authors.forename: Diane
authors.initials: D
authors.lastname: Zimmermann
mesh_terms: D001794:Blood Pressure; D019587:Dietary Supplements; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D011188:Potassium / Q000097:blood* / Q000652:urine; D017419:Potassium, Dietary / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D012964:Sodium / Q000097:blood*
chemical_list: D017419:Potassium, Dietary; D012964:Sodium; D011188:Potassium