Oral potassium supplementation for management of essential hypertension

Importance

Increased dietary potassium intake is thought to be associated with low blood pressure (BP). Whether potassium supplementation may be used as an anti-hypertensive agent is a question that should be answered.

Objective

To assess the effect of oral potassium supplementation on blood pressure in patients with primary hypertension.

Search methods

We searched Medline, Web of Science, Scopus, Cochrane Central Register of Controlled Trials until October 2016. We also screened reference lists of articles and previous reviews. We applied no language restrictions.

Selection criteria

We included randomized placebo-controlled clinical trials addressing the effect of potassium supplementation on primary hypertension for a minimum of 4 weeks.

Data collection and analysis

We extracted data on systolic and diastolic BP (SBP and DBP) at the final follow-up. We explored the heterogeneity across studies using Cochran's test and I² statistic and assessed the probability of publication bias using Begg's and Egger's tests. We reported the mean difference (MD) of SBP and DBP in a random-effects model.

Results

We found a total of 9059 articles and included 23 trials with 1213 participants. Compared to placebo, potassium supplementation resulted in modest but significant reductions in both SBP (MD -4.25 mmHg; 95% CI: -5.96 to -2.53; I² = 41%) and DBP (MD -2.53 mmHg; 95% CI: -4.05 to -1.02; I² = 65%). According to the change-score analysis, based on 8 out of 23 trials, compared to baseline, the mean changes in SBP (MD -8.89 mmHg; 95% CI: -13.67 to -4.11) and DBP (MD -6.42 mmHg; 95% CI: -10.99 to -1.84) was significantly higher in the intervention group than the control group.