Lyanne M Kieneker1, Ron T Gansevoort2, Rudolf A de Boer3, Frank P Brouwers3, Edith Jm Feskens4, Johanna M Geleijnse4, Gerjan Navis2, Stephan Jl Bakker1, Michel M Joosten5. 1. Top Institute Food and Nutrition, Wageningen, Netherlands; Department of Internal Medicine and. 2. Department of Internal Medicine and. 3. Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; and. 4. Top Institute Food and Nutrition, Wageningen, Netherlands; Wageningen University, Division of Human Nutrition, Wageningen, Netherlands. 5. Top Institute Food and Nutrition, Wageningen, Netherlands; Department of Internal Medicine and mmjoosten@gmail.com.
Abstract
BACKGROUND: Observational studies on dietary potassium and risk of cardiovascular disease (CVD) have reported weak-to-modest inverse associations. Long-term prospective studies with multiple 24-h urinary samples for accurate estimation of habitual potassium intake, however, are scarce. OBJECTIVE: We examined the association between urinary potassium excretion and risk of blood pressure-related cardiovascular outcomes. DESIGN: We studied 7795 subjects free of cardiovascular events at baseline in the Prevention of Renal and Vascular End-stage Disease study, a prospective, observational cohort with oversampling of subjects with albuminuria at baseline. Main cardiovascular outcomes were CVD [including ischemic heart disease (IHD), stroke, and vascular interventions], IHD, stroke, and new-onset heart failure (HF). Potassium excretion was measured in two 24-h urine specimens at the start of the study (1997-1998) and midway through follow-up (2001-2003). RESULTS: Baseline median urinary potassium excretion was 70 mmol/24 h (IQR: 56-84 mmol/24 h). During a median follow-up of 10.5 y (IQR: 9.9-10.8 y), a total of 641 CVD, 465 IHD, 172 stroke, and 265 HF events occurred. After adjustment for age and sex, inverse associations were observed between potassium excretion and risk [HR per each 26-mmol/24-h (1-g/d) increase; 95% CI] of CVD (0.87; 0.78, 0.97) and IHD (0.86; 0.75, 0.97), as well as nonsignificant inverse associations for risk of stroke (0.85; 0.68, 1.06) and HF (0.94; 0.80, 1.10). After further adjustment for body mass index, smoking, alcohol consumption, education, and urinary sodium and magnesium excretion, urinary potassium excretion was not statistically significantly associated with risk (multivariable-adjusted HR per 1-g/d increment; 95% CI) of CVD (0.96; 0.85, 1.09), IHD (0.90; 0.81, 1.04), stroke (1.09; 0.86, 1.39), or HF (0.99; 0.83, 1.18). No associations were observed between the sodium-to-potassium excretion ratio and risk of CVD, IHD, stroke, or HF. CONCLUSION: In this cohort with oversampling of subjects with albuminuria at baseline, urinary potassium excretion was not independently associated with a lower risk of cardiovascular events.
BACKGROUND: Observational studies on dietary potassium and risk of cardiovascular disease (CVD) have reported weak-to-modest inverse associations. Long-term prospective studies with multiple 24-h urinary samples for accurate estimation of habitual potassium intake, however, are scarce. OBJECTIVE: We examined the association between urinary potassium excretion and risk of blood pressure-related cardiovascular outcomes. DESIGN: We studied 7795 subjects free of cardiovascular events at baseline in the Prevention of Renal and Vascular End-stage Disease study, a prospective, observational cohort with oversampling of subjects with albuminuria at baseline. Main cardiovascular outcomes were CVD [including ischemic heart disease (IHD), stroke, and vascular interventions], IHD, stroke, and new-onset heart failure (HF). Potassium excretion was measured in two 24-h urine specimens at the start of the study (1997-1998) and midway through follow-up (2001-2003). RESULTS: Baseline median urinary potassium excretion was 70 mmol/24 h (IQR: 56-84 mmol/24 h). During a median follow-up of 10.5 y (IQR: 9.9-10.8 y), a total of 641 CVD, 465 IHD, 172 stroke, and 265 HF events occurred. After adjustment for age and sex, inverse associations were observed between potassium excretion and risk [HR per each 26-mmol/24-h (1-g/d) increase; 95% CI] of CVD (0.87; 0.78, 0.97) and IHD (0.86; 0.75, 0.97), as well as nonsignificant inverse associations for risk of stroke (0.85; 0.68, 1.06) and HF (0.94; 0.80, 1.10). After further adjustment for body mass index, smoking, alcohol consumption, education, and urinary sodium and magnesium excretion, urinary potassium excretion was not statistically significantly associated with risk (multivariable-adjusted HR per 1-g/d increment; 95% CI) of CVD (0.96; 0.85, 1.09), IHD (0.90; 0.81, 1.04), stroke (1.09; 0.86, 1.39), or HF (0.99; 0.83, 1.18). No associations were observed between the sodium-to-potassium excretion ratio and risk of CVD, IHD, stroke, or HF. CONCLUSION: In this cohort with oversampling of subjects with albuminuria at baseline, urinary potassium excretion was not independently associated with a lower risk of cardiovascular events.
Authors: Y Mossavar-Rahmani; D Sotres-Alvarez; W W Wong; C M Loria; M D Gellman; L Van Horn; M H Alderman; J M Beasley; C M Lora; A M Siega-Riz; R C Kaplan; P A Shaw Journal: J Hum Hypertens Date: 2017-02-16 Impact factor: 3.012
Authors: Turtushikh Damba; Arno R Bourgonje; Amaal E Abdulle; Andreas Pasch; Svenja Sydor; Eline H van den Berg; Ron T Gansevoort; Stephan J L Bakker; Hans Blokzijl; Robin P F Dullaart; Harry van Goor; Han Moshage Journal: Liver Int Date: 2020-06-28 Impact factor: 5.828
Authors: Amaal E Abdulle; Arno R Bourgonje; Lyanne M Kieneker; Anne M Koning; S la Bastide-van Gemert; Marian L C Bulthuis; Gerard Dijkstra; Klaas Nico Faber; Robin P F Dullaart; Stephan J L Bakker; Reinold O B Gans; Ron T Gansevoort; Douwe J Mulder; Andreas Pasch; Harry van Goor Journal: BMC Med Date: 2020-05-27 Impact factor: 8.775