Oral Potassium Supplementation Lowers Clinic Blood Pressure in Untreated Primary Hypertension-Systematic Review and Meta-Analysis of Randomized Trials.
Javier Ravichagua Ashiyama, Felix A Medina, Cesar Loza et al.
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In 30 seconds
This systematic review and meta-analysis assessed oral potassium supplementation versus placebo, sodium chloride, or no treatment in adults with untreated primary hypertension. Across 19 randomized trials involving 803 participants, with a median treatment duration of 4 weeks, potassium lowered clinic systolic blood pressure by 5.3 mm Hg (95% CI, 4.4-6.3) and diastolic pressure by 4.5 mm Hg (95% CI, 3.9-5.1). Reductions in 24-hour ambulatory pressure were smaller. Adverse events were more frequent with potassium, while the authors cautioned that heterogeneity and limited ambulatory and safety evidence constrain interpretation.
Key findings
- Clinic systolic blood pressure fell by 5.3 mm Hg (95% CI, 4.4-6.3) with potassium supplementation.
- Clinic diastolic blood pressure fell by 4.5 mm Hg (95% CI, 3.9-5.1).
- Twenty-four-hour ambulatory pressure reductions were 2.8 mm Hg (95% CI, 1.3-4.3) systolic and 3.2 mm Hg (95% CI, 2.2-4.2) diastolic.
- Adverse events occurred more often with potassium than comparators (12.8% versus 3.2%); withdrawals and adverse-event withdrawals were uncommon.
Why it matters
The findings suggest that potassium supplementation can lower clinic blood pressure in untreated primary hypertension, while the smaller ambulatory reductions provide a more cautious estimate of its effect across the day. The higher frequency of adverse events and limited safety evidence are relevant when weighing potential benefit. Short follow-up and substantial heterogeneity mean the pooled estimates should not be treated as definitive.
What to keep in mind
Median follow-up was 4 weeks; heterogeneity was substantial, and ambulatory blood pressure and safety evidence were limited.