The brand new ionic hypothesis of hypertension or any other metabolic issues because of the Resnick 66 are described as the second: 1) enhanced intracellular totally free calcium supplements and you will smaller intracellular totally free magnesium dictate brand new level of vasoconstriction otherwise vasodilatation 66 ; 2) raised glucose and you can low-density lipoprotein cholesterol levels viewpoints increase intracellular calcium supplements and you can/or straight down intracellular magnesium in the vascular simple muscle mass cells 68 ; 3) blood pressure levels, insulin opposition, and type II diabetic issues mellitus are associated with increased intracellular calcium and you will reduced intracellular magnesium, and that most of the answer diet 69 ; 4) dietary in addition to reduces intracellular calcium accounts 70 ; 5) weight reduction calcium supplements-suppressible hormonal such parathyroid hormones (PTH) and 1,twenty-five vitamin D are vasoactive and you will offer calcium use when you look at the vascular smooth muscles structure and cardiac muscle mass 71 ; 6) the higher the fresh new PTH quantity, more the reduced amount of BP, and the greater the brand new lack of PTH and you may step one,25 vitamin D, the more the fresh BP prevention 72 ; 7) individuals with salt-sensitive and painful and you may calcium supplements-sensitive blood pressure level provides increased intracellular calcium supplements PTH and step one,twenty-five vitamin D, but lower intracellular magnesium 73 ; 8) fat loss calcium reverses abnormal calcium indicator and you will lowers BP 74 ; 9) diet potassium decrease urinary calcium supplements excretion and you can 1,twenty-five vitamin D plasma levels 75 ; and you may 10) magnesium intake minimizes cells calcium supplements accumulation. 76
The bottom line is, the overall aftereffect of eating plan toward BP depends upon this new net share of numerous nutrition into the cytosolic totally free vitamins such potassium, calcium, and magnesium. Steady-state nutrient levels decided by the the lead ionic consequences into the glucose otherwise calcium additionally the ionic consequences to the hormones (PTH, step one,25 vitamin D). 72 A dialogue of a few a lot more clinical results of some nutrients on BP was has just advertised from the Diary away from Systematic Hypertension. 77
Results
The average US dietary intake of potassium is 45 mEq/d with a potassium-to-sodium ratio of <1:2. 78 This is less than the recommended intake of 4700 mg/d (121 mEq/d) of potassium, with a potassium/sodium ratio of >5:1. Low potassium intake in the United States is considered a contributor to the prevalence of hypertension. 27 Therefore, if Americans were able to increase their potassium intake alone, the number of adults with known hypertension might decrease. As data from TOHP, 35 PREMIER, 79 and the Trial of Preventing Hypertension (TROPHY) 80 indicate, lifestyle changes such as weight loss, salt restriction, increased exercise, and dietary changes may prevent the progression to hypertension. The results of the DASH studies further indicate that a diet rich in fruits and vegetables is important for the prevention of hypertension and major public health problems such as coronary heart disease and stroke. An increase in potassium with a decrease in sodium is probably the most important dietary choice (after weight loss) that should be implemented to reduce CVD. Unfortunately, the population that could most benefit from increased potassium, magnesium, and calcium in the diet may have the least access to these more expensive food types (fruits and vegetables).
Disclosure:
Article assistance is financed by the Unilever’s Vow Institute to possess Cardiovascular health Nutrients as well as the authors obtained an honorarium, funded by the Unilever’s Promise Institute to have Cardiovascular health Nourishment, having work invested getting ready this article.
Indicate systolic and you will diastolic blood pressure level within standard and you can throughout for every input month, predicated on eating plan, for 379 clients that have complete categories of a week hypertension measurements. Reprinted having permission out-of Appel mais aussi al. 10
Multiple meta-analyses 25-twenty eight report a critical loss of BP that have potassium supplements (Table We). A young meta-research by Cappuccio and you may MacGregor twenty-five of 19 health-related examples examining the outcome from potassium supplements into the BP found that oral potassium products somewhat decreased each other systolic BP and you can diastolic BP (5.nine mm Hg and you may step 3.cuatro mm Hg, respectively). Other meta-data regarding 33 randomized regulated samples (RCTs)26 including reported you to potassium supplementation rather lowered BP. The fresh BP-minimizing impact try so much more obvious during the blacks rate my date stl compared to whites and you will those taking a nutrients saturated in sodium chloride. Just as in the earlier meta-analyses, the fresh new BP impulse try greater when you look at the hypertensive than simply normotensive people (3.5/2.5 mm Hg vs 0.97/0.34 mm Hg, respectively), that was regarding borderline statistical advantages. An effective meta-study out-of of 40 sodium products and you may twenty seven potasisum products by the Geleijnse et al. twenty-seven as well as revealed that a lower life expectancy intake from sodium and improved intake of potassium are important members on avoidance regarding blood pressure level. Although not, a newer meta-analysis of 5 RCTs, presented from the Dickinson and you may couples, 28 reported that potassium supplementation led to mathematically nonsignificant decreases in the each other systolic BP (step three.nine mm Hg) and you can diastolic BP (1.5 mm Hg). It needs to be appreciated you to certain training with potassium supplements was in fact off small cycle and you will integrated small quantities of people.
