Effects of potassium supplementation on office, home, and 24-h blood pressure in patients with essential hypertension

Abstract

An increase in potassium (K) intake may lower blood pressure (BP), but inconsistent results have been obtained in clinical trials. We studied the effects of K supplementation in hypertensive patients with monitoring of home and ambulatory BP. Fifty-five patients with essential hypertension (26 men, 29 women, 36–77 years old) participated in this study. A 4-week K supplementation period and 4-week control period were assigned in a randomized crossover manner. During the K period, the subjects were given 64 mmol/day of K as slow-release KCl tablets. Office, home, and 24-h BP, as well as serum and urinary electrolytes, were measured at the end of each period. In the control period, office, home, and 24-h BP were 151 ± 2/88 ± 1 (mean ± SE), 138 ± 1/83 ± 1, and 137 ± 1/81 ± 1 mm Hg, respectively. Serum K increased from 4.15 ± 0.04 to 4.42 ± 0.05 mmol/L, and urinary K increased from 54 ± 2 to 96 ± 3 mmol/day with the K supplementation. Office, home, and 24-h BP were significantly lower in the K period than in the control period, although the differences were small (2.7 ± 1.1/1.4 ± 0.6, 3.6 ± 0.9/1.7 ± 0.5, 3.4 ± 1.0/1.2 ± 0.5 mm Hg, respectively). Changes in home and 24-h systolic BP with K supplementation were highly significant ( P < .001), compared with office BP ( P < .05). The change in 24-h systolic BP was correlated negatively with baseline BP and urinary Na/K ratio, and positively with baseline urinary K excretion. The changes in daytime and nighttime BP were comparable. These results indicate that increasing K intake lowers BP in hypertensive subjects, especially in those with higher BP and lower K intake. Our study supports the usefulness of K supplementation in the treatment of hypertension, although its antihypertensive effect may be small.