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Effects of sodium and potassium supplementation on blood pressure and arterial stiffness: a fully controlled dietary intervention study

Abstract

We performed a randomised, placebo-controlled, crossover study to examine the effects of sodium and potassium supplementation on blood pressure (BP) and arterial stiffness in untreated (pre)hypertensive individuals. During the study, subjects were on a fully controlled diet that was relatively low in sodium and potassium. After a 1-week run-in period, subjects received capsules with supplemental sodium (3 g d−1, equals 7.6 g d−1 of salt), supplemental potassium (3 g d−1) or placebo, for 4 weeks each, in random order. Fasting office BP, 24-h ambulatory BP and measures of arterial stiffness were assessed at baseline and every 4 weeks. Of 37 randomized subjects, 36 completed the study. They had a mean pre-treatment BP of 145/81 mm Hg and 69% had systolic BP 140 mm Hg. Sodium excretion was increased by 98 mmol per 24 h and potassium excretion by 63 mmol per 24 h during active interventions, compared with placebo. During sodium supplementation, office BP was significantly increased by 7.5/3.3 mm Hg, 24-h BP by 7.5/2.7 mm Hg and central BP by 8.5/3.6 mm Hg. During potassium supplementation, 24-h BP was significantly reduced by 3.9/1.6 mm Hg and central pulse pressure by 2.9 mm Hg. Pulse wave velocity and augmentation index were not significantly affected by sodium or potassium supplementation. In conclusion, increasing the intake of sodium caused a substantial increase in BP in subjects with untreated elevated BP. Increased potassium intake, on top of a relatively low-sodium diet, had a beneficial effect on BP. Arterial stiffness did not materially change during 4-week interventions with sodium or potassium.

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Acknowledgements

The research is funded by TI Food and Nutrition, a public–private partnership on pre-competitive research in food and nutrition. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. We gratefully acknowledge the assistance of Harrie Robins, Sarah Mount and Danielle Schoenaker in the conduct of the study. We thank the dieticians for dietary calculations and catering, Karin Borgonjen-van den Berg for randomisation and blinding procedures, Anita Bruggink-Hoopman and Diana Emmen-Benink for blood sampling, Marlies Diepeveen-de Bruin for analysing duplicate diets and Hendriek Boshuizen for statistical support.

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Correspondence to L Gijsbers.

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Gijsbers, L., Dower, J., Mensink, M. et al. Effects of sodium and potassium supplementation on blood pressure and arterial stiffness: a fully controlled dietary intervention study. J Hum Hypertens 29, 592–598 (2015). https://doi.org/10.1038/jhh.2015.3

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