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Abstract: TH-PO428

The Feasibility of Interventions to Increase Potassium Intake for Hypertension: A Systematic Review of the Evidence

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Zaree, Maryam, University of Ottawa Faculty of Medicine, Windsor, Ontario, Canada
  • Ruzicka, Marcel, University of Ottawa Faculty of Medicine, Windsor, Ontario, Canada
  • Hiremath, Swapnil, University of Ottawa, Ottawa, Ontario, Canada
Background

Increased potassium (K) intake has been reported to decrease blood pressure (BP) in animal studies as well as clinical trials. On this basis, major organizations including the American Heart Association recommend increasing K intake, preferably by diet, as a non pharmacological mean of reducing BP. However, it is not clear if the interventions for efficaciously increasing K intake are reproducible or feasible for translation into public health. Hence, we conducted a systematic review of the evidence to review this from randomized controlled trials (RCTs).

Methods

We conducted a literature search using an information specialist of MEDLINE, EMBASE and Cochrane CENTRAL till November 2017. Two reviewers selected RCTs that were in adults, with an intervention aimed at increasing K intake, with blood pressure as an outcome. From RCTs which reported both a significant change in BP and K using 24 hour urine K, we evaluated the interventions for ease of reproducibility and feasibility based on prespecified criteria.

Results

The initial search retrieved 1199 non-duplicate citations. After applying eligibility criteria, 90 studies were selected for inclusion. In 31 studies, the change in BP or K was not significant. Of the remaining 59 studies which reported a significant change in K and BP, 47 reported a change in K based on 24 hour urinary K measurement. 32/47 studies used a K supplement, with details provided on dose and administration to make it both reproducible and feasible. 15/47 studies used a dietary intervention, of which in 4, the intervention was not described in sufficient detail to be reproducible.The remaining 11 studies were feeding trials, with intervention consisting of provision of prepared meals, or of food items on a daily basis to make them unfeasible for routine clinical practice.

Conclusion

Dietary potassium interventions from trials in which there was a significant change in K based on 24 hour urine, and a significant change in BP, and which describe methods insufficient detail to be reproduced, are not feasible for routine clinical practice.

Funding

  • Clinical Revenue Support