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Hemodynamic, renal, and hormonal responses to changes in dietary potassium in normotensive and hypertensive man: Long-term antihypertensive effect of potassium supplementation in essential hypertension

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Summary

The hemodynamic, hormonal, and renal responses to alterations in dietary potassium were studied in normotensive and hypertensive subjects. In a short-term study, nine normotensive and nine hypertensive young men received a normal diet and low potassium, high potassium, and high potassium/low sodium diets for 1 week, each. The long-term effect of potassium supplementation (normal diet plus 96 mmol KCl/d for 8 weeks) was evaluated in 17 patients with essential hypertension. Blood pressure did not change significantly during short-term alterations of potassium intake but decreased during long-term supplementation (from 152.2±3.5/99.6±1.9 mm Hg to 137.4±2.9/89.1±1.4 mm Hg). High dietary potassium induced a significant but transient natriuresis. Plasma potassium concentration was increased during long- but not during short-term high potassium intake. In contrast to plasma renin activity (PRA) and aldosterone, urinary kallikrein was consistently stimulated during long-term potassium supplementation. The plasma concentrations of adrenaline and noradrenaline were significantly higher in hypertensive than in normotensive subjects and were not markedly altered by the dietary changes. It is concluded that long- but not short-term potassium supplementation lowers blood pressure in patients with essential hypertension. The antihypertensive effect may be mediated by potassium-induced natriuresis, by a stimulation of Na-K-ATPase secondary to increased plasma potassium levels, and/or by a modulation of the renin-angiotensin-aldosterone, kallikrein-kinin, and sympathetic nervous systems.

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Abbreviations

MAP:

mean arterial pressure

Na-K-ATPase:

sodium-potassium ATPase

PRA:

plasma renin activity

References

  1. Meneely GR, Battarbee HD (1976) High sodium-low potassium environment and hypertension. Am J Cardiol 38:768–785

    Google Scholar 

  2. MacGregor GA (1983) Dietary sodium and potassium intake and blood pressure. Lancet I:750–753

    Google Scholar 

  3. Addison WLT (1928) The use of sodium chloride, potassium chloride, sodium bromide, and potassium bromide in cases of arterial hypertension which are amenable to potassium chloride. Can Med Assoc J 18:281–285

    Google Scholar 

  4. McQuarrie I, Thompson WH, Anderson JA (1936) Effects of excessive ingestion of sodium and potassium salts on carbohydrate metabolism and blood pressure in diabetic children. J. Nutr 11:77–101

    Google Scholar 

  5. Priddle WW Observations on the management of hypertension. Can Med Assoc J 25:5–8

  6. MacGregor GA, Smith SJ, Markandu ND, Banks RA, Sagnella GA (1982) Moderate potassium supplementation in essential hypertension. Lancet II:567–570

    Google Scholar 

  7. Iimura O, Kijima T, Kikuchi K, Miyama A, Ando T, Nakao T, Takigami Y (1981) Studies on the hypotensive effect of high potassium intake in patients with essential hypertension. Clin Sci 61:77s-80s

    Google Scholar 

  8. Richards AM, Nichols MG, Espiner EA, Ikram H, Maslowski AH, Hamilton EJ, Wells JE (1984) Blood pressure response to moderate sodium restriction and to potassium supplementation in mild essential hypertension. Lancet II:757–761

    Google Scholar 

  9. Freis ED (1982) Should mild hypertension be treated? N Engl J Med 307:306–309

    Google Scholar 

  10. Haber E, Koerner T, Page LB, Kliman B, Purnode A (1969) Application of a radioimmunoassay for angiotensin I to the physiologic measurement of plasma renin activity in normal human subjects. J Clin Endocrinol 29:1349–1355

    Google Scholar 

  11. Vetter W, Vetter H, Siegenthaler W (1973) Radioimmunoassay for aldosterone without chromatography. II. Determination of plasma aldosterone. Acta Endocrinol (Kbh) 74:558–567

    Google Scholar 

  12. Vetter W, Vetter H, Siegenthaler W (1973) Radioimmunoassay for aldosterone without chromatography. I. Determination of urinary-18-glucuronide excretion. Acta Endocrinol (Kbh) 74:548–557

    Google Scholar 

  13. Da Prada M, Zürcher G (1976) Simultaneous radioenzymatic determination of plasma and tissue adrenaline, noradrenaline and dopamine within the femtomole range. Life Sci 19:1161–1174

    Google Scholar 

  14. Overlack A, Stumpe KO, Ressel C, Kolloch R, Zywzock W, Krück F (1980) Decreased urinary kallikrein activity and elevated blood pressure normalized by orally applied kallikrein in essential hypertension. Klin Wochenschr 58:37–42

    Google Scholar 

  15. Morgan TO (1982) The effect of potassium and bicarbonate ions on the rise in blood pressure caused by sodium chloride. Clin Sci 63:407s-409s

    Google Scholar 

  16. Holly JMP, Goodwin FJ, Evans SJW, VandenBurg MJ, Ledingham JM (1981) Re-analysis of data in two Lancet papers on the effect of dietary sodium and potassium on blood pressure. Lancet II:1384–1387

    Google Scholar 

  17. Skrabal F, Auböck, J, Hörtnagl H (1981) Low sodium/high potassium diet for prevention of hypertension: probable mechanisms of action. Lancet II:895–900

    Google Scholar 

  18. Young DB, McCaa RE, Pan Y-J, Guyton AC (1976) The natriuretic and hypotensive effects of potassium. Circ Res 38:1184–1189

    Google Scholar 

  19. Bauer JH, Gautner WC (1979) Effect of potassium chloride on plasma renin activity and plasma aldosterone during sodium restriction in normal man. Kidney Int 15:286–293

    Google Scholar 

  20. Brandis M, Keyes J, Windhager EE (1972) Potassium-induced inhibition of proximal tubular fluid reabsorption in rats. Am J Physiol 222:421–427

    Google Scholar 

  21. Kahn M, Bohrer NK (1967) Effect of potassium-induced diuresis on renal concentration and dilution. Am J Physiol 212:1365–1375

    Google Scholar 

  22. Willis T (1976) Pharmaceutica rationalis. Dring, Herper and Leigh, London, p 74

    Google Scholar 

  23. Suzuki H, Kondo K, Saruta T (1981) Effect of potassium chloride on the blood pressure in two-kidney, one clip Goldblatt hypertensive rats. Hypertension 3:566–573

    Google Scholar 

  24. Sealey JE, Clark I, Bull MB, Laragh JH (1970) Potassium balance and the control of renin secretion. J Clin Invest 49:2119–2127

    Google Scholar 

  25. Brunner HR, Baer L, Sealey JE, Ledingham JGG, Laragh JH (1970) The influence of potassium administration and of potassium deprivation on plasma renin in normal and hypertensive subjects. J Clin Invest 49:2128–2138

    Google Scholar 

  26. Vander AJ (1970) Direct effects of potassium on renin secretion and renal function. Am J Physiol 219:455–459

    Google Scholar 

  27. Campbell WB, Schmitz JM (1978) Effect of alterations in dietary potassium on the pressor and steroidogenic effects of angiotensins II and III. Endocrinology 103:2098–2104

    Google Scholar 

  28. Overlack A, Stumpe KO, Kolloch R, Ressel C, Krück F (1981) Antihypertensive effect of orally administered glandular kallikrein in essential hypertension. Results of a double blind study. Hypertension 3:I18-I21

    Google Scholar 

  29. Vinci JM, Zusman RM, Izzo JL, Bowden RE, Horwitz D, Pisano JJ, Keiser HR (1979) Human urinary and plasma kinins. Relationship to sodium-retaining steroids and plasma renin activity. Circ Res 44:228–237

    Google Scholar 

  30. Scicli AG, Diaz MA, Carretero OA (1983) Effect of pH and amiloride on the intrarenal formation of kinins. Am J Physiol 245:F198-F203

    Google Scholar 

  31. Horwitz D, Margolius HS, Keiser HR (1978) Effects of dietary potassium and race on urinary excretion of kallikrein and aldosterone in man. J Clin Endocrinol Metab 47:296–299

    Google Scholar 

  32. Marks E, Frech M, Proud D, Keiser HR (1982) Effect of alterations in extracellular fluid volume on urinary kallikrein in the conscious rat. Hypertension 4:625–633

    Google Scholar 

  33. Goldstein DS (1983) Plasma catecholamines and essential hypertension. An analytical review. Hypertension 5:86–99

    Google Scholar 

  34. Masuo K, Ogihara T, Kumahara Y, Yamatadoni A, Wada H (1983) Plasma norepinephrine and dietary sodium intake in normal subjects and patients with essential hypertension. Hypertension 5:767–771

    Google Scholar 

  35. Dietz R, Schömig A, Rascher W, Strasser R, Ganten U, Kübler W (1981) Partial replacement of sodium by potassium in the diet restores impaired noradrenaline inactivation and lowers blood pressure in stroke-prone spontaneously hypertensive rats. Clin Sci 61:69s-71s

    Google Scholar 

  36. Bulpitt CJ, Shipley MJ, Semmence A (1981) Blood pressure and plasma sodium and potassium. Clin Sci 61:85s-87s

    Google Scholar 

  37. Beretta-Piccoli C, Davies DL, Boddy K, Brown JJ, Cumming AMM, East BW, Fraser R, Lever AF, Padfield PL, Semple PF, Robertson JIS, Weidmann P, Williams ED (1982) Relation of arterial pressure with body sodium, body potassium and plasma potassium in essential hypertension. Clin Sci 63:257–270

    Google Scholar 

  38. Ueshima H, Tanigaki M, Iida M, Shimamoto T, Konishi M, Komachi Y (1981) Hypertension, salt, and potassium. Lancet I:504

    Google Scholar 

  39. Maxwell MH, Fitzsimmons E, Harrist R, Hotchkiss J, Langford HG, Payne GH, Schneider KA, Varaday P (1983) Baseline laboratory examination characteristics of the hypertensive participants. In: Daugherty SA, Entwisle G (eds) Hypertension and Detection and Follow-Up Program. Baseline characteristics of the enumerated, screened, and hypertensive participants. Hypertension 5:IV133-IV159

    Google Scholar 

  40. Chen W-T, Brace RA, Scott JB, Anderson DK, Haddy FJ (1970) The mechanism of the vasodilator action of potassium. Proc Soc Exp Biol Med 140:820–824

    Google Scholar 

  41. Overbeck HW, Derifield RS, Pamnani MB, Sözen T (1974) Attenuated vasodilator responses to K in essential hypertension. J Clin Invest 53:678–686

    Google Scholar 

  42. Losse H, Wehmeyer H, Wessels F (1960) The water and electrolyte content of erythrocytes in arterial hypertension. Klin Wochenschr 38:393–395

    Google Scholar 

  43. Poston L, Sewell RB, Wikinson SP Richardson PJ, Williams R, Clarkson EM, MacGregor GA, DeWardener HE (1981) Evidence for a circulating sodium transport inhibitor in essential hypertension. Br Med J 282:847–849

    Google Scholar 

  44. Blaustein MP (1977) Sodium ions, calcium ions, and blood pressure regulation and hypertension: a reassessment and a hypothesis. Am J Physiol 232:C165-C173

    Google Scholar 

  45. Lawrason FD, Alpert E, Mohr FL, McMahon FG (1965) Ulcerative-obstructive lesions of the small intestine. J Am Med Assoc 191:641–644

    Google Scholar 

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Authors and Affiliations

  1. Medizinische Universitäts-Poliklinik, Bonn

    A. Overlack, K. O. Stumpe, B. Moch, A. Ollig, R. Kleinmann, H. -M. Müller, R. Kolloch & F. Krück

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  1. A. Overlack
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  2. K. O. Stumpe
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  3. B. Moch
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  4. A. Ollig
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  5. R. Kleinmann
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  6. H. -M. Müller
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  7. R. Kolloch
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  8. F. Krück
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Additional information

The study was supported in part by the Ministerium für Wissenschaft und Forschung, Nordrhein-Westfalen (FA-92/14)

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Overlack, A., Stumpe, K.O., Moch, B. et al. Hemodynamic, renal, and hormonal responses to changes in dietary potassium in normotensive and hypertensive man: Long-term antihypertensive effect of potassium supplementation in essential hypertension. Klin Wochenschr 63, 352–360 (1985). https://doi.org/10.1007/BF01731654

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  • DOI: https://doi.org/10.1007/BF01731654

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