Key result
High urinary potassium excretion was not associated with the risk of hypertension (OR 0.95) or correlated with blood pressure, although mean excretion was higher in normotensive individuals.
Why the study?
The evidence base regarding the association between urinary potassium and blood pressure or risk of hypertension was inconsistent.
Does urinary potassium excretion correlate with blood pressure and the risk of hypertension in the general population?
Meta-Analysis (n=16,174)
Does urinary potassium excretion correlate with blood pressure and the risk of hypertension in the general population?
Odds Ratio: 0.95 (95% CI 0.79–1.13)
In this meta-analysis of observational studies, 24-hour urinary potassium excretion was not significantly correlated with blood pressure or the risk of hypertension, though normotensive individuals had slightly higher mean potassium excretion.
Does not support using urinary potassium excretion for hypertension risk assessment; leaves open any protective role in prospective cohorts.
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. MATERIALS AND METHODS: 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-h 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 16,174 subjects, were identified for inclusion in the present meta-analysis, and 21 effect sizes were extracted. Pooled mean potassium excretion was 3.46 mmol/24 h higher in normotensive individuals compared with hypertensive subjects (95% confidence interval [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). CONCLUSION: 24 h 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.
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Rouhani et al. (2020) conducted a meta-analysis in Hypertension (n=16,174). High urinary potassium excretion vs. Lower urinary potassium excretion was evaluated on Risk of hypertension (OR 0.95, 95% CI 0.79, 1.13). High urinary potassium excretion was not associated with the risk of hypertension (OR 0.95) or correlated with blood pressure, although mean excretion was higher in normotensive individuals.
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