Short-Term RCT of Increased Dietary Potassium from Potato or Potassium Gluconate: Effect on Blood Pressure, Microcirculation, and Potassium and Sodium Retention in Pre-Hypertensive-to-Hypertensive Adults

Michael S Stone, Berdine R Martin, Connie M Weaver, Michael S Stone, Berdine R Martin, Connie M Weaver

Abstract

Increased potassium intake has been linked to improvements in cardiovascular and other health outcomes. We assessed increasing potassium intake through food or supplements as part of a controlled diet on blood pressure (BP), microcirculation (endothelial function), and potassium and sodium retention in thirty pre-hypertensive-to-hypertensive men and women. Participants were randomly assigned to a sequence of four 17 day dietary potassium treatments: a basal diet (control) of 60 mmol/d and three phases of 85 mmol/d added as potatoes, French fries, or a potassium gluconate supplement. Blood pressure was measured by manual auscultation, cutaneous microvascular and endothelial function by thermal hyperemia, utilizing laser Doppler flowmetry, and mineral retention by metabolic balance. There were no significant differences among treatments for end-of-treatment BP, change in BP over time, or endothelial function using a mixed-model ANOVA. However, there was a greater change in systolic blood pressure (SBP) over time by feeding baked/boiled potatoes compared with control (-6.0 mmHg vs. -2.6 mmHg; p = 0.011) using contrast analysis. Potassium retention was highest with supplements. Individuals with a higher cardiometabolic risk may benefit by increasing potassium intake. This trial was registered at ClinicalTrials.gov as NCT02697708.

Keywords: blood pressure; cardiometabolic risk; controlled feeding study; microcirculation; potassium; retention; sodium.

Conflict of interest statement

The authors declare no conflict of interest. The sponsor had no role in the design, execution, interpretation, or writing of the study.

Figures

Figure 1
Figure 1
Flow Diagram of Potassium Hypertension and Retention Study.
Figure 2
Figure 2
Blood pressure throughout each intervention. (A) Systolic blood pressure (SBP) and (B) diastolic blood pressure (DBP) means (N = 30) for each measurement day in each intervention phase.
Figure 3
Figure 3
Secondary BP outcome: change in BP over time. * denotes significant difference (p < 0.05) between potato and other groups.
Figure 4
Figure 4
Primary BP outcome: comparison of end-of-treatment (A) systolic blood pressure (SBP) and (B) diastolic blood pressure (DBP) for all intervention phases with an adjustment for baseline BP.
Figure 5
Figure 5
(A) Urinary (N = 28) and (B) Fecal (N = 20) excretion of potassium and sodium in hypertensive adults fed a typical potassium intake (control) and supplemented potassium through food (baked or boiled potatoes or French fries (FF)) or supplement. * denotes significant differences between control and potassium groups (p < 0.05) for potassium retention. # denotes significant differences between groups for sodium retention (i.e., control and supplement were both significantly different from potato and FF, but not each other). NS, no significant differences. To convert to mmol/d for potassium, divide by 39; and for sodium, divide by 23.
Figure 6
Figure 6
Potassium retention as mg/d (A) and percent (%) of intake (B) in hypertensive adults on a controlled diet. * denotes significant difference (p < 0.05) between supplement and other groups. NS, not significant differences. To convert to mmol/d, divide by 39.
Figure 7
Figure 7
Differences in sodium retention as mg/d (A) and percent (%) of intake (B) in hypertensives on a controlled diet. * denotes significant difference (p < 0.05) between potato and other groups. To convert to mmol/d, divide by 23.

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