Dietary electrolyte intake and blood pressure in older subjects: the Rotterdam Study

Geleijnse, Johanna M.; Witteman, J. C. M.; Breeijen, J.H. den; Hofman, Amy; Jong, Paulus T. V. M. de; Pols, Hans; Grobbee, D.E.

doi:10.1097/00004872-199606000-00009

Cited by 46 publications

(28 citation statements)

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“…Hypokalemia can also predispose patients to developing diastolic dysfunction, digoxin toxicity, and insulin resistance, all of which increase the risk for cardiovascular events and death (12)(13)(14)(15)(16). Dietary potassium depletion has been linked to the genesis of hypertension, and supplementation can improve BP control (17)(18)(19). Data from the cardiovascular literature suggest that serum potassium levels Ͻ4.0 mmol/L portend a worse prognosis among those who have a history of heart failure or acute myocardial infarction (20,21).…”

Section: Discussionmentioning

confidence: 99%

Serum Potassium and Outcomes in CKD

Korgaonkar¹,

Tilea²,

Gillespie³

et al. 2010

Clinical Journal of the American Society of Nephrology

197

159

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Background and objectives:The relationship between serum potassium (S K ) and mortality in chronic kidney disease (CKD) has not been systematically investigated.Design, setting, participants, & measurements: We examined the predictors and mortality association of S K in the Renal Research Institute CKD Study cohort, wherein 820 patients with CKD were prospectively followed at four US centers for an average of 2.6 years. Predictors of S K were investigated using linear and repeated measures regression models. Associations between S K and mortality, the outcomes of ESRD, and cardiovascular events in time-dependent Cox models were examined.Results: The mean age was 60.5 years, 80% were white, 90% had hypertension, 36% had diabetes, the average estimated GFR was 25.4 ml/min per 1.73 m 2 , and mean baseline S K was 4.6 mmol/L. Higher S K was associated with male gender, lower estimated GFR and serum bicarbonate, absence of diuretic and calcium channel blocker use, diabetes, and use of angiotensinconverting enzyme inhibitors and/or statins. A U-shaped relationship between S K and mortality was observed, with mortality risk significantly greater at S K <4.0 mmol/L compared with 4.0 to 5.5 mmol/L. Risk for ESRD was elevated at S K <4 mmol/L in S K categorical models. Only the composite of cardiovascular events or death as an outcome was associated with higher S K (>5.5).Conclusions: Although clinical practice usually emphasizes greater attention to elevated S K in the setting of CKD, our results suggest that patients who have CKD and low or even low-normal S K are at higher risk for dying than those with mild to moderate hyperkalemia.

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Section: Discussionmentioning

confidence: 99%

Serum Potassium and Outcomes in CKD

Korgaonkar¹,

Tilea²,

Gillespie³

et al. 2010

Clinical Journal of the American Society of Nephrology

197

159

View full text Add to dashboard Cite

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“…55 y were assessed by a semi-quantitative food frequency questionnaire (Geleijnse et al, 1996). After adjustment for age, sex, BMI and alcohol intake, an increase in potassium intake of 1 g=day was associated with a 0.9 mmHg lower systolic and a 0.8 mmHg lower diastolic blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Relationship of urinary sodium/potassium excretion and calcium intake to blood pressure and prevalence of hypertension among older Chinese vegetarians

2003

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Objective: To examine the associations of dietary sodium and potassium, as reflected by the urinary sodium=potassium excretion, and calcium intake with blood pressure and the prevalence of hypertension among older Chinese vegetarians in Hong Kong. Design: Cross-sectional study. Setting: Research clinic in a teaching hospital in Hong Kong. Subjects: A total of 111 ambulatory vegetarians over the age of 55 were recruited from members of religious organizations or old age hostels. Main outcome measures: Hypertension was defined as supine blood pressure > 140=90 mmHg or a history of hypertension. Dietary sodium, potassium and calcium intakes were assessed by 24 h recall method or fasting urinary sodium or potassium= creatinine ratios. Results: Seventy-one subjects (64%) were found to have hypertension. Compared with normotensive subjects, hypertensive subjects had lower calcium intake (411 AE s.d. 324 vs 589 AE 428 mg, P ¼ 0.04), but higher urinary sodium=creatinine ratio (32.6 AE 19.3 vs 21.0 AE 12.4, P ¼ 0.00) and sodium=potassium ratio (4.7 AE 2.8 vs 3.4 AE 2.3, P ¼ 0.02). Among 88 subjects not taking diuretics or antihypertensive drugs, systolic blood pressure was related to calcium intake (r ¼ 7 0.40), urinary sodium=creatinine ratio (r ¼ 0.39), urinary sodium=potassium ratio (r ¼ 0.30) and age (r ¼ 0.23). Diastolic blood pressure was related to urinary sodium=creatinine (r ¼ 0.29). Twenty-three subjects with high urinary sodium=potassium and low calcium intake and 16 subjects with low urinary sodium=potassium ratio and high calcium intake differed markedly with respect to systolic blood pressure (159 AE 26 vs 130 AE 15 mmHg) and prevalence of hypertension (78% vs 25%). Conclusions: Older Chinese vegetarians are predisposed to hypertension because of their sodium-rich but calcium-deficient diets.

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“…3,4 However, the results of the different studies were inconsistent. [5][6][7][8][9][10][11][12][13][14][15][16] Some methodological problems were considered to be responsible for this heterogeneity. For example, differences in the method of sampling, dietary data collection and assessing calcium intake are possible causes.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study on association of calcium intake with blood pressure in Japanese population

et al. 2002

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To investigate the association of calcium intake independently of other nutrients already known as predictors of hypertension, a cross-sectional study was carried out on the same population in Japan as used for the INTERSALT study. Dietary calcium intake was estimated from a 1-day 24-h recall. Sodium and potassium intakes were evaluated by 24-h urinary excretion. Data from 476 subjects aged 20-59 years, 230 men and 246 women, were analysed. The mean dietary calcium intake ranged from 557 to 608 mg/day among men, and from 528 to 639 mg/day among women. Among men, the pooled estimate of the regression coefficients of blood pressure (mm Hg) per 100 mg increase of calcium intake, adjusted for age and body mass index (BMI), were −0.42 mm Hg for systolic blood pressure (SBP) and −0.35 mm Hg for diastolic blood pressure (DBP), but

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Dietary electrolyte intake and blood pressure in older subjects: the Rotterdam Study

Cited by 46 publications

References 0 publications

Serum Potassium and Outcomes in CKD

Serum Potassium and Outcomes in CKD

Relationship of urinary sodium/potassium excretion and calcium intake to blood pressure and prevalence of hypertension among older Chinese vegetarians

A cross-sectional study on association of calcium intake with blood pressure in Japanese population

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