Association between urinary potassium excretion and blood pressure: A systematic review and meta-analysis of observational studies

Rahele Ziaei , Gholamreza Askari, Sohar Foshati, Cain Clark, Hamid Zolfaghari, Mohammad Rouhani

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Abstract

Aims and background: The evidence base regarding the association between urinary potassium and blood pressure (BP), or risk of hypertension, is inconsistent. Therefore, we sought to conduct a qualitative and quantitative literature review on the association between potassium excretion and BP.
Methodology: Medline, Scopus, Web of Science, Science Direct, and Google Scholar were searched up to June 2020. All observational studies that reported BP and measured potassium excretion in overnight or 24-hour urine samples were included. Correlation coefficients, mean urinary potassium excretion, and odds ratio (ORs) of hypertension were extracted from the included studies. There were no language or publication date restrictions.
Results: Overall, twelve observational studies, including 16174 subjects, were identified for inclusion in the present meta-analysis, and 21 effect sizes were extracted. Pooled mean potassium excretion was 3.46 mmol/24h higher in normotensive individuals compared with hypertensive subjects (95% CI: 0.61, 6.31). High urinary potassium excretion was not associated with the risk of hypertension (OR: 0.95; 95% CI: 0.79, 1.13). The pooled correlation coefficient between BP and urinary potassium was not significant (ES: 0.01; 95% CI: -0.03, 0.05). However, a subgroup analysis by age indicated a significant positive correlation between urinary potassium and systolic BP in children (ES: 0.12; 95% CI: 0.04, 0.19).
Principal conclusions: 24h urinary potassium excretion was not correlated to BP and risk of hypertension. In contrast, mean urinary potassium excretion was higher in normotensive individuals compared with hypertensive counterparts. Future studies should focus on the association between different sources of dietary potassium and BP.
Original languageEnglish
Article number116
JournalJournal of Research in Medical Sciences
Volume25
Issue number12
DOIs
Publication statusPublished - 30 Dec 2020

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Keywords

  • Blood pressure
  • potassium excretion
  • urinary potassium

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