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Effects of potassium supplementation on plasma aldosterone: a systematic review and meta-analysis in humans

Journal of Hypertension, ISSN: 1473-5598, Vol: 42, Issue: 9, Page: 1581-1589
2024
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Article Description

Objectives: Effects of potassium supplementation on blood pressure (BP) may be offset by an increase in plasma aldosterone. The magnitude of potassium-dependent regulation of aldosterone secretion in humans is not fully characterized; it is not clear whether this is mediated by activation of the renin – angiotensin – aldosterone system (RAAS), as a result of a reduction in BP or other mechanisms. We performed a systematic review and meta-analysis of clinical trials assessing effects of potassium on plasma aldosterone and renin in adult individuals. Methods: This was carried out in accordance with PRISMA guidelines. Three databases were searched: MEDLINE, EMBASE and CENTRAL. Titles were firstly screened by title and abstract for relevance before full-text articles were assessed for eligibility. The keywords used included ‘‘aldosterone’’, ‘‘potassium’’ and ‘‘RAAS’’. Results: 6395 articles were retrieved and after title/ abstract screening, 123 full-text articles were assessed for eligibility. Thirty-six met the prespecified inclusion/ exclusion criteria (of which 18/36 also reported systolic BP). Potassium supplementation caused a significant decrease in systolic BP (mean difference [95% CI] -3.69 mmHg [-4.91, -2.46], P < 0.001) and increase in serum potassium (R0.37 [0.23, 0.52] mmol/l, P < 0.001). There was an increase in plasma aldosterone (standardized difference 0.426 [0.299, 0.553], P < 0.001) but not in plasma renin activity. Meta-regression showed a significant positive correlation between change in plasma aldosterone and change in serum potassium (P < 0.001). Conclusions: Potassium supplementation increases plasma aldosterone concentrations, which correlates with the increase in serum potassium concentration which does not appear to be mediated by an increase in plasma renin activity.

Bibliographic Details

McNally, Ryan J; Farukh, Bushra; Chowienczyk, Philip J; Faconti, Luca

Ovid Technologies (Wolters Kluwer Health)

Medicine; Biochemistry, Genetics and Molecular Biology

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