Aims A potassium replete diet is associated with lower blood pressure (BP) and lower risk of cardiovascular disease (CVD). Whether these associations differ between men and women and whether they depend on daily sodium intake is unknown. Methods and results An analysis was performed in 11 267 men and 13 696 women from the EPIC-Norfolk cohort. Twenty-four hour excretion of sodium and potassium, reflecting intake, was estimated from sodium and potassium concentration in spot urine samples using the Kawasaki formula. Linear and Cox regression were used to explore the association between potassium intake, systolic BP (SBP), and CVD events (defined as hospitalization or death due to CVD). After adjustment for confounders, interaction by sex was found for the association between potassium intake and SBP (P < 0.001). In women, but not in men, the inverse slope between potassium intake and SBP was steeper in those within the highest tertile of sodium intake compared with those within the lowest tertile of sodium intake (P < 0.001 for interaction by sodium intake). Both in men and women, higher potassium intake was associated with a lower risk of CVD events, but the hazard ratio (HR) associated with higher potassium intake was lower in women than in men [highest vs. lowest potassium intake tertile: men: HR 0.93, 95% confidence interval (CI) 0.87–1.00; women: HR 0.89, 95% CI 0.83–0.95, P = 0.033 for interaction by sex]. Conclusion The association between potassium intake, SBP, and CVD events is sex specific. The data suggest that women with a high sodium intake in particular benefit most from a higher potassium intake with regard to SBP.

中文翻译：

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钾摄入量、血压和心血管结局之间的性别特异性关联：EPIC-诺福克研究


目标 富含钾的饮食与降低血压 (BP) 和降低心血管疾病 (CVD) 风险相关。这些关联在男性和女性之间是否存在差异以及它们是否取决于每日钠摄入量尚不清楚。方法和结果 对来自 EPIC-Norfolk 队列的 11 267 名男性和 13 696 名女性进行了分析。反映摄入量的二十四小时钠和钾排泄量是使用川崎公式根据点尿样本中的钠和钾浓度估算的。使用线性和 Cox 回归探讨钾摄入量、收缩压 (SBP) 和 CVD 事件（定义为 CVD 导致的住院或死亡）之间的关联。调整混杂因素后，发现钾摄入量与 SBP 之间存在性别交互作用（P < 0.001）。在女性中，但在男性中，钾摄入量与 SBP 之间的反斜率在钠摄入量最高三分位内的女性中比在钠摄入量最低三分位内的女性更陡（钠摄入量相互作用的 P < 0.001）。无论是男性还是女性，较高的钾摄入量与较低的 CVD 事件风险相关，但女性与较高钾摄入量相关的风险比 (HR) 低于男性 [最高钾摄入量与最低钾摄入量三分位数：男性：HR 0.93，95% 置信区间 (CI) 0.87–1.00；女性：HR 0.89，95% CI 0.83–0.95，P = 0.033（按性别划分的交互作用）]。结论 钾摄入量、SBP 和 CVD 事件之间的关联具有性别特异性。数据表明，钠摄入量高的女性尤其能从较高的钾摄入量中受益，从而降低收缩压。