Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials

source extracted confidence: high 2026-04-09
#adolescent #adult #aged #antihypertensive-agents #blood-pressure

Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials

Filippini et al., 2020 | J Am Heart Assoc | Meta Analysis

Citation

Filippini Tommaso, Naska Androniki, ... Vinceti Marco. Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2020-Jun-16;9(12):e015719. doi:10.1161/JAHA.119.015719

Abstract

Background Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. Methods and Results We performed a meta-analysis to explore the dose-response relationship between potassium supplementation and BP in randomized-controlled trials with a duration ≥4 weeks using the recently developed 1-stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U-shaped relationship between 24-hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U-shaped relationship. The BP-lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug-treated hypertension but not in their untreated counterparts. Conclusions We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.

Key Findings

Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.

Outcomes Measured

  • blood pressure
  • systolic blood pressure
  • diastolic blood pressure

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition hypertension

MeSH Terms

  • Adolescent
  • Adult
  • Aged
  • Antihypertensive Agents
  • Blood Pressure
  • Dietary Supplements
  • Female
  • Humans
  • Hypertension
  • Male
  • Middle Aged
  • Potassium Deficiency
  • Potassium, Dietary
  • Randomized Controlled Trials as Topic
  • Recommended Dietary Allowances
  • Risk Assessment
  • Risk Factors
  • Treatment Outcome
  • Young Adult

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Systematic Review
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09