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Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials

Journal of Human Hypertension volume 17, pages 471–480 (2003)Cite this article

Abstract

The objective of the study was to assess the blood pressure response to changes in sodium and potassium intake and examine effect modification by age, gender, blood pressure, body weight and habitual sodium and potassium intake. Randomised trials of sodium reduction or potassium supplementation and blood pressure were identified through reference lists of systematic reviews and an additional MEDLINE search (January 1995–March 2001). A total of 40 sodium trials and 27 potassium trials in adults with a minimum duration of 2 weeks were selected for analysis. Data on changes in electrolyte intake and blood pressure during intervention were collected, as well as data on mean age, gender, body weight, initial electrolyte intake and initial blood pressure of the trial populations. Blood pressure effects of changes in electrolyte intake were assessed by weighted metaregression analysis, overall and in strata of trial population characteristics. Analyses were repeated with adjustment for potential confounders. Sodium reduction (median: −77 mmol/24 h) was associated with a change of −2.54 mmHg (95% CI: −3.16, −1.92) in systolic blood pressure and −1.96 mmHg (−2.41, −1.51) in diastolic blood pressure. Corresponding values for increased potassium intake (median: 44 mmol/24 h) were −2.42 mmHg (−3.75, −1.08) and −1.57 mmHg (–2.65, –0.50). Blood pressure response was larger in hypertensives than normotensives, both for sodium (systolic: −5.24 vs −1.26 mmHg, P<0.001; diastolic: −3.69 vs −1.14 mmHg, P<0.001) and potassium (systolic: −3.51 vs −0.97 mmHg, P=0.089; diastolic: −2.51 vs −0.34 mmHg, P=0.074). In conclusion, reduced intake of sodium and increased intake of potassium could make an important contribution to the prevention of hypertension, especially in populations with elevated blood pressure.

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Acknowledgements

This work was supported by an unrestricted grant from the Factors Affecting Hypertension Task Force of the European Branch of the International Life Sciences Institute (ILSI Europe; E-mail: info@ilsieurope.be). Industry members of this task force are Frito Lay (PepsiCo), Kellogg, RHM Technology, Unilever, and Valio. The opinions expressed herein are those of the authors and do not necessarily represent the views of ILSI Europe.

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  1. Division of Human Nutrition & Epidemiology, Wageningen University, The Netherlands

    J M Geleijnse & F J Kok

  2. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, The Netherlands

    J M Geleijnse & D E Grobbee

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Geleijnse, J., Kok, F. & Grobbee, D. Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials. J Hum Hypertens 17, 471–480 (2003). https://doi.org/10.1038/sj.jhh.1001575

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Keywords

  • blood pressure
  • sodium
  • potassium
  • sodium sensitivity
  • randomised trials
  • metaregression analysis

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