Document Detail


Potassium depletion exacerbates essential hypertension.
MedLine Citation:
PMID:  2058867     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the effect of potassium depletion on blood pressure in patients with essential hypertension. DESIGN: Double-blind, randomized, crossover study, with each patient serving as his or her own control. SETTING: Clinical research center at a university hospital. PATIENTS: Twelve patients with hypertension. INTERVENTIONS: Patients were placed on 10-day isocaloric diets providing a daily potassium intake of either 16 mmol or 96 mmol. The intake of sodium (120 mmol/d) and other minerals was kept constant. On day 11 each patient received a 2-litre isotonic saline infusion over 4 hours. MEASUREMENTS: Blood pressure; urinary excretion rates for sodium, potassium, calcium, and phosphorous; glomerular filtration rate; renal plasma flow; and plasma levels of vasoactive hormones. MAIN RESULTS: With low potassium intake, systolic blood pressure increased (P = 0.01) by 7 mm Hg (95% CI, 3 mm Hg to 11 mm Hg) and diastolic pressure increased (P = 0.04) by 6 mm Hg (CI, 1 mm Hg to 11 mm Hg), whereas plasma potassium concentration decreased (P less than 0.001) by 0.8 mmol/L (CI, 0.4 to 1.0 mmol/L). In response to a 2-litre isotonic saline infusion, the mean arterial pressure increased similarly on both diets but reached higher levels on low potassium intake (115 +/- 2 mm Hg compared with 109 +/- 2 mm Hg, P = 0.03). Potassium depletion was associated with a decrease in sodium excretion (83 +/- 6 mmol/d compared with 110 +/- 5 mmol/d, P less than 0.001). Plasma renin activity and plasma aldosterone concentrations also decreased in patients during low potassium intake, but concentrations of arginine vasopressin and atrial natriuretic peptide, glomerular filtration rate, and renal plasma flow were unchanged. Further, low potassium intake increased urinary excretion of calcium and phosphorus and of plasma immunoreactive parathyroid hormone levels. CONCLUSION: Dietary potassium restriction increases blood pressure in patients with essential hypertension. Both sodium retention and calcium depletion may contribute to the increase in blood pressure during potassium depletion.
Authors:
G G Krishna; S C Kapoor
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  115     ISSN:  0003-4819     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  1991 Jul 
Date Detail:
Created Date:  1991-07-29     Completed Date:  1991-07-29     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  77-83     Citation Subset:  AIM; IM    
Affiliation:
Temple University, Philadelphia, Pennsylvania.
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MeSH Terms
Descriptor/Qualifier:
Adult
Diet
Double-Blind Method
Electrolytes / metabolism
Female
Humans
Hypertension / complications,  metabolism,  physiopathology*
Male
Middle Aged
Natriuresis
Potassium / administration & dosage,  urine
Potassium Deficiency / complications*,  metabolism
Random Allocation
Sodium, Dietary / administration & dosage
Grant Support
ID/Acronym/Agency:
R23HL37372/HL/NHLBI NIH HHS; RR00040/RR/NCRR NIH HHS; RR003934/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Electrolytes; 0/Sodium, Dietary; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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