BackgroundEpidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain.Methods and ResultsWe performed a meta‐analysis to explore the dose‐response relationship between potassium supplementation and BP in randomized‐controlled trials with a duration ≥4 weeks using the recently developed 1‐stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U‐shaped relationship between 24‐hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U‐shaped relationship. The BP‐lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug‐treated hypertension but not in their untreated counterparts.ConclusionsWe identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.

中文翻译：

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钾摄入量和血压：随机对照试验的剂量反应荟萃分析。

背景流行病学研究（包括试验）表明，钾摄入量与血压之间存在关联（血压）。然而，这种关系的强度和形状尚不确定。方法和结果我们进行了荟萃分析，探讨了钾补充剂和钾补充剂之间的剂量反应关系。血压使用最近开发的1阶三次样条回归模型进行的持续时间≥4周的随机对照试验。该模型允许使用至少两个暴露类别的试验。我们确定了32项合格试验。大多数是在成人高血压患者中使用交叉设计和补充钾的剂量范围为30至140 mmol / d进行的。我们观察到24小时活跃和控制臂的钾排泄量差异与U型关系血压 水平，随着 血压 差异超过30 mmol / d时的还原作用和 血压高于差异≈80mmol / d。已完成的钾排泄分析也确定了U型关系。的血压在高血压和较高钠摄入量的参与者中，补充钾的降低作用更强。的血压 高血压药物治疗的高血压患者中钾的排泄增加，但未治疗的高血压患者则没有。结论我们确定了钾摄入与收缩期和舒张期之间存在非线性关系。 血压，尽管估计 血压由于试验的局限性，应谨慎解释高钾摄入的影响。我们的研究结果表明，摄入足够的钾可以降低钾的摄入量。血压 水平，但建议应避免过量补充钾，尤其是在特定的亚组中。