Urinary potassium excretion and 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.

Bibliographic Details

Main Authors:	Kieneker, L.M., Gansevoort, R.T., de Boer, R., Brouwers, Frank P., Feskens, E.J.M., Geleijnse, J.M., Navis, G., Bakker, Stephan L.J., Joosten, M.M.
Format:	Article/Letter to editor biblioteca
Language:	English
Subjects:	Cardiovascular disease, Epidemiology, Potassium, Risk factors, Sodium,
Online Access:	https://research.wur.nl/en/publications/urinary-potassium-excretion-and-risk-of-cardiovascular-events
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