title: Effects of Potassium Magnesium Citrate Supplementation on 24-Hour Ambulatory Blood Pressure and Oxidative Stress Marker in Prehypertensive and Hypertensive Subjects.
abstract: Diet rich in fruits, vegetables, and dairy products, known as the Dietary Approaches to Stop Hypertension (DASH) diet, is known to reduce blood pressure (BP) in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in hypertensive and nonhypertensive humans. However, the main nutritional components responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of potassium magnesium citrate (KMgCit), potassium chloride (KCl), and potassium citrate (KCit) to allow dissociation of the three components of K, Mg, and citrate on 24-hour ambulatory BP and urinary 8-isoprostane in hypertensive and prehypertensive subjects, using a randomized crossover design. We found that KCl supplementation for 4 weeks induced a significant reduction in nighttime SBP compared with placebo (116 ± 12 vs 121 ± 15 mm Hg, respectively, p <0.01 vs placebo), whereas KMgCit and KCit had no significant effect in the same subjects (118 ± 11 and 119 ± 13 mm Hg, respectively, p >0.1 vs placebo). In contrast, urinary 8-isoprostane was significantly reduced with KMgCit powder compared with placebo (13.5 ± 5.7 vs 21.1 ± 10.5 ng/mgCr, respectively, p <0.001), whereas KCl and KCit had no effect (21.4 ± 9.1 and 18.3 ± 8.4, respectively, p >0.1 vs placebo). In conclusion, our study demonstrated differential effects of KCl and KMgCit supplementation on BP and the oxidative stress marker in prehypertensive and hypertensive subjects. Clinical significance of the antioxidative effect of KMgCit remains to be determined in future studies.
authors.affiliation: Cardiology Division Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas. Electronic address: wanpen.vongpatanasin@utsouthwestern.edu.
authors.forename: Wanpen
authors.initials: W
authors.lastname: Vongpatanasin
authors.affiliation: Cardiology Division Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Poghni
authors.initials: P
authors.lastname: Peri-Okonny
authors.affiliation: Cardiology Division Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Velasco
authors.affiliation: Cardiology Division Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Debbie
authors.initials: D
authors.lastname: Arbique
authors.affiliation: Cardiology Division Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Zhongyun
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Priya
authors.initials: P
authors.lastname: Ravikumar
authors.affiliation: Division of Biostatistics, Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Beverly
authors.initials: B
authors.lastname: Adams-Huet
authors.affiliation: Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Nephrology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Physiology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Orson W
authors.initials: OW
authors.lastname: Moe
authors.affiliation: Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Charles Y C
authors.initials: CYC
authors.lastname: Pak
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002951:Citrates / Q000627:therapeutic use*; D018592:Cross-Over Studies; D019587:Dietary Supplements; D015237:Dinoprost / Q000031:analogs & derivatives / Q000652:urine; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000378:metabolism; D016014:Linear Models; D017616:Magnesium Compounds / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011188:Potassium / Q000378:metabolism; D011189:Potassium Chloride / Q000627:therapeutic use*; D019357:Potassium Citrate / Q000627:therapeutic use*; D017680:Potassium Compounds / Q000627:therapeutic use*; D058246:Prehypertension / Q000188:drug therapy* / Q000378:metabolism; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents; D002951:Citrates; D004338:Drug Combinations; D017616:Magnesium Compounds; D017680:Potassium Compounds; C075750:8-epi-prostaglandin F2alpha; D011189:Potassium Chloride; D015237:Dinoprost; D019357:Potassium Citrate; D011188:Potassium; C066902:potassium-magnesium citrate