The role of dietary potassium in hypertension and diabetes

Journal of Physiology and Biochemistry

Volumn 72, Issue 1, 2016, Pages 93-106

  Ekmekcioglu, Cem ^a   Elmadfa, Ibrahim ^b   Meyer, Alexa L ^b   Moeslinger, Thomas ^c  

^a Medical University of Vienna   (Austria)

^b UNIVERSITY OF VIENNA   (Austria)

^c MEDICAL UNIVERSITY OF VIENNA   (Austria)

Author keywords

Diabetes; Epidemiology; Hypertension; Mechanisms; Physiology; Potassium

Indexed keywords

ANGIOTENSIN RECEPTOR ANTAGONIST; DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; GLUCOSE; INSULIN; PLACEBO; POTASSIUM; SODIUM; THIAZIDE DIURETIC AGENT;

ANTIHYPERTENSIVE ACTIVITY; ANTIOXIDANT ACTIVITY; BLOOD PRESSURE REGULATION; CLINICAL TRIAL (TOPIC); DIABETES MELLITUS; DIET SUPPLEMENTATION; DIETARY INTAKE; GLUCOSE BLOOD LEVEL; HEART PROTECTION; HUMAN; HYPERTENSION; INSULIN RELEASE; META ANALYSIS (TOPIC); NONHUMAN; PANCREAS ISLET BETA CELL; POTASSIUM INTAKE; REVIEW; RISK REDUCTION; SMOOTH MUSCLE RELAXATION; SODIUM INTAKE; VASCULAR ENDOTHELIUM; VASCULAR SMOOTH MUSCLE; VASODILATATION; BLOOD PRESSURE; PATHOPHYSIOLOGY;

BLOOD PRESSURE; DIABETES MELLITUS; HUMANS; HYPERTENSION; POTASSIUM;

EID: 84959099082     PISSN: 11387548     EISSN: 18778755     Source Type: Journal    
DOI: 10.1007/s13105-015-0449-1     Document Type: Review

References (84)

1. Aburto NJ, Hanson S, Gutierrez H, Hooper L, Elliott P, Cappuccio FP (2013) Effect of increased potassium intake on cardiovascular risk factors and disease: systematic review and meta-analyses. BMJ 346:f1378
2. Adrogue HJ, Madias NE (2007) Sodium and potassium in the pathogenesis of hypertension. N Engl J Med 356:1966–1978
3. Ando K, Matsui H, Fujita M, Fujita T (2010) Protective effect of dietary potassium against cardiovascular damage in salt-sensitive hypertension: possible role of its antioxidant action. Curr Vasc Pharmacol 8:59–63
4. Andraws R, Brown DL (2007) Effect of inhibition of the renin-angiotensin system on development of type 2 diabetes mellitus (meta-analysis of randomized trials). Am J Cardiol 99:1006–1012
5. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM, Bray GA, Vogt TM, Cutler JA, Windhauser MM et al (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 336:1117–1124
6. Appel LJ, Brands MW, Daniels SR, Karanja N, Elmer PJ, Sacks FM (2006) Dietary approaches to prevent and treat hypertension: a scientific statement from the American Heart Association. Hypertension 47:296–308
7. Azadbakht L, Mirmiran P, Esmaillzadeh A, Azizi T, Azizi F (2005) Beneficial effects of a dietary approaches to stop hypertension eating plan on features of the metabolic syndrome. Diabetes Care 28:2823–2831
8. Bulpitt CJ (1981) Sodium excess or potassium lack as a cause of hypertension: a discussion paper. J R Soc Med 74:896–900
9. Bussemaker E, Hillebrand U, Hausberg M, Pavenstadt H, Oberleithner H (2010) Pathogenesis of hypertension: interactions among sodium, potassium, and aldosterone. Am J Kidney Dis 55:1111–1120
10. Cappuccio FP, MacGregor GA (1991) Does potassium supplementation lower blood pressure? A meta-analysis of published trials. J Hypertens 9:465–473
11. Carter P, Gray LJ, Troughton J, Khunti K, Davies MJ (2010) Fruit and vegetable intake and incidence of type 2 diabetes mellitus: systematic review and meta-analysis. BMJ 341:c4229
12. Chatterjee R, Yeh HC, Shafi T, Selvin E, Anderson C, Pankow JS, Miller E, Brancati F (2010) Serum and dietary potassium and risk of incident type 2 diabetes mellitus: the Atherosclerosis Risk in Communities (ARIC) study. Arch Intern Med 170:1745–1751
13. Chatterjee R, Yeh HC, Edelman D, Brancati F (2011) Potassium and risk of type 2 diabetes. Expert Rev Endocrinol Metab 6:665–672
14. Chatterjee R, Biggs ML, de Boer IH, Brancati FL, Svetkey LP, Barzilay J, Djousse L, Ix JH, Kizer JR, Siscovick DS et al (2015) Potassium and glucose measures in older adults: the cardiovascular health study. J Gerontol Ser A Biol Med Sci 70:255–261
15. Coca SG, Perazella MA, Buller GK (2005) The cardiovascular implications of hypokalemia. Am J Kidney Dis 45:233–247
16. Colditz GA, Manson JE, Stampfer MJ, Rosner B, Willett WC, Speizer FE (1992) Diet and risk of clinical diabetes in women. Am J Clin Nutr 55:1018–1023
17. D-A-CH, German Nutrition Society, Austrian Nutrition Society, Swiss Society for Nutrition. Reference values for nutrient intake. 2nd ed., 1st release. Umschau, Frankfurt/Main, Germany, 2015. Chapter on sodium, chloride and potassium available online in German at: https://www.dge.de/wissenschaft/referenzwerte/natrium-chlorid-kalium/
18. Dawson CM, Atwater I, Rojas E (1982) Potassium-induced insulin release and voltage noise measurements in single mouse islets of Langerhans. J Membr Biol 64:33–43
19. Dickinson HO, Nicolson DJ, Campbell F, Beyer FR, Mason J (2006) Potassium supplementation for the management of primary hypertension in adults. Cochrane Database Syst Rev CD004641
20. Dietary dietary guidelines advisory committee (2011) Report of the on the dietary guidelines for Americans, 2010. U.S. Department of Agriculture, Agricultural Research S, Washington, DC
21. Dluhy RG, Axelrod L, Williams GH (1972) Serum immunoreactive insulin and growth hormone response to potassium infusion in normal man. J Appl Physiol 33:22–26
22. Doenyas-Barak K, Beberashvili I, Vinker S (2014) Serum potassium is an age-dependent risk factor for pre-diabetes and diabetes in the Israeli population. Diab Vasc Dis Res 11:103–109
23. Dorner TE, Genser D, Krejs G, Slany J, Watschinger B, Ekmekcioglu C, Rieder A (2013) Hypertension and nutrition. Position paper of the Austrian Nutrition Society. Herz 38:153–162
24. Eaton SB, Konner M (1985) Paleolithic nutrition. A consideration of its nature and current implications. N Engl J Med 312:283–289
25. Ekmekcioglu C, Blasche G, Dorner TE (2013) Too much salt and how we can get rid of it. Forsch Komplementmed 20:454–460
26. Elliott WJ, Meyer PM (2007) Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 369:201–207
27. Elmadfa I, Hasenegger V, Wagner K, Putz P, et al (2012) Österreichischer Ernährungsbericht 2012. [Austrian Nutrition Report 2012]. 1st ed., Vienna: BMG. Available at (in German): http://www.bmg.gv.at/cms/home/attachments/4/5/3/CH1048/CMS1348749794860/oeb12.pdf
28. Elmadfa I, Aign W, Muskat E, Fritzsche D (2013) Die große GU Nährwert Kalorien Tabelle. [The extensive GU food composition table] 2014/15. Gräfe & Unzer, München
29. Fulgoni VL 3rd, Keast DR, Bailey RL, Dwyer J (2011) Foods, fortificants, and supplements: where do Americans get their nutrients? J Nutr 141:1847–1854
30. Geleijnse JM, Kok FJ, Grobbee DE (2003) Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials. J Hum Hypertens 17:471–480
31. Goldner MG, Zarowitz H, Akgun S (1960) Hyperglycemia and glycosuria due to thiazide derivatives administered in diabetes mellitus. N Engl J Med 262:403–405
32. Haddy FJ, Vanhoutte PM, Feletou M (2006) Role of potassium in regulating blood flow and blood pressure. Am J Physiol Regul Integr Comp Physiol 290:R546–R552
33. He FJ, MacGregor GA (2002) Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens 16:761–770
34. He FJ, MacGregor GA (2003) Potassium: more beneficial effects. Climacteric J Int Menopause Soc 6(Suppl 3):36–48
35. He FJ, Marciniak M, Carney C, Markandu ND, Anand V, Fraser WD, Dalton RN, Kaski JC, MacGregor GA (2010) Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives. Hypertension 55:681–688
36. Heianza Y, Hara S, Arase Y, Saito K, Totsuka K, Tsuji H, Kodama S, Hsieh SD, Yamada N, Kosaka K, Sone H (2011) Low serum potassium levels and risk of type 2 diabetes: the Toranomon Hospital Health Management Center Study 1 (TOPICS 1). Diabetologia 54:762–766
37. Helderman JH, Elahi D, Andersen DK, Raizes GS, Tobin JD, Shocken D, Andres R (1983) Prevention of the glucose intolerance of thiazide diuretics by maintenance of body potassium. Diabetes 32:106–111
38. Houston MC (1988) The effects of antihypertensive drugs on glucose intolerance in hypertensive nondiabetics and diabetics. Am Heart J 115:640–656
39. Houston MC, Harper KJ (2008) Potassium, magnesium, and calcium: their role in both the cause and treatment of hypertension. J Clin Hypertens 10:3–11
40. Houston MC (2011) The importance of potassium in managing hypertension. Curr Hypertens Rep 13:309–317
41. Howell SL, Taylor KW (1968) Potassium ions and the secretion of insulin by islets of Langerhans incubated in vitro. Biochem J 108:17–24
42. Hu G, Jousilahti P, Peltonen M, Lindstrom J, Tuomilehto J (2005) Urinary sodium and potassium excretion and the risk of type 2 diabetes: a prospective study in Finland. Diabetologia 48:1477–1483
43. IOM (2005) Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. National Academy Press, Washington DC
44. Ishimitsu T, Tobian L, Sugimoto K, Everson T (1996) High potassium diets reduce vascular and plasma lipid peroxides in stroke-prone spontaneously hypertensive rats. Clin Exp Hypertens 18:659–673
45. Iwamoto T (2006) Vascular Na+/Ca2+ exchanger: implications for the pathogenesis and therapy of salt-dependent hypertension. Am J Physiol Regul Integr Comp Physiol 290:R536–R545
46. Kido M, Ando K, Onozato ML, Tojo A, Yoshikawa M, Ogita T, Fujita T (2008) Protective effect of dietary potassium against vascular injury in salt-sensitive hypertension. Hypertension 51:225–231
47. Knot HJ, Zimmermann PA, Nelson MT (1996) Extracellular K(+)-induced hyperpolarizations and dilatations of rat coronary and cerebral arteries involve inward rectifier K(+) channels. J Physiol 492(Pt 2):419–430
48. Krishna GG, Chusid P, Hoeldtke RD (1987) Mild potassium depletion provokes renal sodium retention. J Lab Clin Med 109:724–730
49. Krishna GG, Miller E, Kapoor S (1989) Increased blood pressure during potassium depletion in normotensive men. N Engl J Med 320:1177–1182
50. Krishna GG (1990) Effect of potassium intake on blood pressure. J Am Soc Nephrol 1:43–52
51. Lee H, Lee J, Hwang SS, Kim S, Chin HJ, Han JS, Heo NJ (2013) Potassium intake and the prevalence of metabolic syndrome: the Korean National Health and Nutrition Examination Survey 2008–2010. PLoS One 8:e55106
52. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M et al (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 380:2224–2260
53. Liu Z, Peng J, Lu F, Zhao Y, Wang S, Sun S, Zhang H, Diao Y (2013) Salt loading and potassium supplementation: effects on ambulatory arterial stiffness index and endothelin-1 levels in normotensive and mild hypertensive patients. J Clin Hypertens 15:485–496
54. McCabe RD, Bakarich MA, Srivastava K, Young DB (1994) Potassium inhibits free radical formation. Hypertension 24:77–82
55. Meisinger C, Stockl D, Ruckert IM, Doring A, Thorand B, Heier M, Huth C, Belcredi P, Kowall B, Rathmann W (2013) Serum potassium is associated with prediabetes and newly diagnosed diabetes in hypertensive adults from the general population: the KORA F4-study. Diabetologia 56:484–491
56. Meissner HP, Henquin JC, Preissler M (1978) Potassium dependence of the membrane potential of pancreatic B-cells. FEBS Lett 94:87–89
57. Morris RC Jr, Sebastian A, Forman A, Tanaka M, Schmidlin O (1999) Normotensive salt sensitivity: effects of race and dietary potassium. Hypertension 33:18–23
58. Mukete BN, Rosendorff C (2013) Effects of low-dose thiazide diuretics on fasting plasma glucose and serum potassium—a meta-analysis. J Am Soc Hypertens 7:454–466
59. Oberleithner H, Callies C, Kusche-Vihrog K, Schillers H, Shahin V, Riethmuller C, Macgregor GA, de Wardener HE (2009) Potassium softens vascular endothelium and increases nitric oxide release. Proc Natl Acad Sci U S A 106:2829–2834
60. Ogihara T, Asano T, Ando K, Sakoda H, Anai M, Shojima N, Ono H, Onishi Y, Fujishiro M, Abe M et al (2002) High-salt diet enhances insulin signaling and induces insulin resistance in Dahl salt-sensitive rats. Hypertension 40:83–89
61. Penney MD (2014) Sodium, water and potassium. Clinical biochemistry-metabolic and clinical aspects. In: Marshall WJ, Lapsley M, Day AP, Ayling RM (eds.) Elsevier
62. Porth CM (2009) Disorders of blood pressure regulation. Porth’s pathophysiology. In: Hannon RA, Pooler C, Porth CM (eds.) Lippincott
63. Rapoport MI, Hurd HF (1964) Thiazide-induced glucose intolerance treated with potassium. Arch Intern Med 113:405–408
64. Rave K, Heise T, Weyer C, Sawicki P, Heinemann L (1999) Measurement of insulin sensitivity: influence of potassium supply during euglycaemic glucose clamps in healthy volunteers. Exp Clin Endocrinol Diabetes 107:313–317
65. Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS et al (2012) Heart disease and stroke statistics—2012 update: a report from the American Heart Association. Circulation 125:e2–e220
66. Rowe JW, Tobin JD, Rosa RM, Andres R (1980) Effect of experimental potassium deficiency on glucose and insulin metabolism. Metab Clin Exp 29:498–502
67. Schmid D, Stolzlechner M, Sorgner A, Bentele C, Assinger A, Chiba P, Moeslinger T (2012) An abundant, truncated human sulfonylurea receptor 1 splice variant has prodiabetic properties and impairs sulfonylurea action. Cell Mol Life Sci 69:129–148
68. Shin D, Joh HK, Kim KH, Park SM (2013) Benefits of potassium intake on metabolic syndrome: the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Atherosclerosis 230:80–85
69. Smith SR, Klotman PE, Svetkey LP (1992) Potassium chloride lowers blood pressure and causes natriuresis in older patients with hypertension. J Am Soc Nephrol 2:1302–1309
70. Sun K, Lu J, Jiang Y, Xu M, Xu Y, Zhang J, Xu B, Sun J, Sun W, Ren C et al (2014) Low serum potassium level is associated with nonalcoholic fatty liver disease and its related metabolic disorders. Clin Endocrinol 80:348–355
71. Thornley-Brown D, Wang X, Wright JT Jr, Randall OS, Miller ER, Lash JP, Gassman J, Contreras G, Appel LJ, Agodoa LY, Cheek D (2006) Differing effects of antihypertensive drugs on the incidence of diabetes mellitus among patients with hypertensive kidney disease. Arch Intern Med 166:797–805
72. Tocci G, Paneni F, Palano F, Sciarretta S, Ferrucci A, Kurtz T, Mancia G, Volpe M (2011) Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and diabetes: a meta-analysis of placebo-controlled clinical trials. Am J Hypertens 24:582–590
73. Triplitt CL (2012) Examining the mechanisms of glucose regulation. Am J Manag Care 18:S4–S10
74. van Bommel E, Cleophas T (2012) Potassium treatment for hypertension in patients with high salt intake: a meta-analysis. Int J Clin Pharmacol Ther 50:478–482
75. Weaver CM (2013) Potassium and health. Adv Nutr 4:368S–377S
76. Weir MR, Rolfe M (2010) Potassium homeostasis and renin-angiotensin-aldosterone system inhibitors. Clin J Am Soc Nephrol 5:531–548
77. Welch AA, Fransen H, Jenab M, Boutron-Ruault MC, Tumino R, Agnoli C, Ericson U, Johansson I, Ferrari P, Engeset D et al (2009) Variation in intakes of calcium, phosphorus, magnesium, iron and potassium in 10 countries in the European Prospective Investigation into Cancer and Nutrition study. Eur J Clin Nutr 63(Suppl 4):S101–S121
78. Whelton PK, He J, Cutler JA, Brancati FL, Appel LJ, Follmann D, Klag MJ (1997) Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA 277:1624–1632
79. Wilkins RW (1959) New drugs for the treatment of hypertension. Ann Intern Med 50:1–10
80. Yang BC, Li DY, Weng YF, Lynch J, Wingo CS, Mehta JL (1998) Increased superoxide anion generation and altered vasoreactivity in rabbits on low-potassium diet. Am J Physiol 274:H1955–H1961
81. Yang SN, Shi Y, Yang G, Li Y, Yu J, Berggren PO (2014) Ionic mechanisms in pancreatic beta cell signaling. Cell Mol Life Sci 71:4149–4177
82. Zhou MS, Kosaka H, Yoneyama H (2000) Potassium augments vascular relaxation mediated by nitric oxide in the carotid arteries of hypertensive Dahl rats. Am J Hypertens 13:666–672
83. Zicha J, Dobesova Z, Behuliak M, Kunes J, Vaneckova I (2011) Preventive dietary potassium supplementation in young salt-sensitive Dahl rats attenuates development of salt hypertension by decreasing sympathetic vasoconstriction. Acta Physiol 202:29–38
84. Zillich AJ, Garg J, Basu S, Bakris GL, Carter BL (2006) Thiazide diuretics, potassium, and the development of diabetes: a quantitative review. Hypertension 48:219–224