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Meta ‐ Analysis of Potassium Intake and the Risk of Stroke

View Article: PubMed Central - PubMed

ABSTRACT

Background: The possibility that lifestyle factors such as diet, specifically potassium intake, may modify the risk of stroke has been suggested by several observational cohort studies, including some recent reports. We performed a systematic review and meta‐analysis of existing studies and assessed the dose–response relation between potassium intake and stroke risk.

Methods and results: We reviewed the observational cohort studies addressing the relation between potassium intake, and incidence or mortality of total stroke or stroke subtypes published through August 6, 2016. We carried out a meta‐analysis of 16 cohort studies based on the relative risk (RR) of stroke comparing the highest versus lowest intake categories. We also plotted a pooled dose–response curve of RR of stroke according to potassium intake. Analyses were performed with and without adjustment for blood pressure. Relative to the lowest category of potassium intake, the highest category of potassium intake was associated with a 13% reduced risk of stroke (RR=0.87, 95% CI 0.80–0.94) in the blood pressure–adjusted analysis. Summary RRs tended to decrease when original estimates were unadjusted for blood pressure. Analysis for stroke subtypes yielded comparable results. In the spline analysis, the pooled RR was lowest at 90 mmol of potassium daily intake (RRs=0.78, 95% CI 0.70–0.86) in blood pressure–adjusted analysis, and 0.67 (95% CI 0.57–0.78) in unadjusted analysis.

Conclusions: Overall, this dose–response meta‐analysis confirms the inverse association between potassium intake and stroke risk, with potassium intake of 90 mmol (≈3500 mg)/day associated with the lowest risk of stroke.

No MeSH data available.


Related in: MedlinePlus

Pooled dose–response association between potassium intake and risk of stroke (solid line) in a meta‐analysis modeling potassium intake with restricted cubic splines in a multivariate random‐effects model, with (A) and without (B) adjustment for blood pressure. The relative risks are plotted on the log scale, with 25 mmol of daily potassium intake serving as referent category. Dashed lines represent the 95% CI for the spline model.
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jah31793-fig-0006: Pooled dose–response association between potassium intake and risk of stroke (solid line) in a meta‐analysis modeling potassium intake with restricted cubic splines in a multivariate random‐effects model, with (A) and without (B) adjustment for blood pressure. The relative risks are plotted on the log scale, with 25 mmol of daily potassium intake serving as referent category. Dashed lines represent the 95% CI for the spline model.

Mentions: In spline regression analysis (Figure 6A), we observed a decrease in the pooled RR up to around 90 mmol/day potassium intake (≈3500 mg/day), based on the most adjusted model. At this cut point of intake, the RR was 0.78 (95% CI 0.70–0.86), while above it the RR flattened and if any slightly increased above 130 mmol/day, though there was substantial uncertainty in this upper range of the distribution. Based on RRs not adjusted for blood pressure, a U‐shaped dose–response curve was observed (Figure 6B). Similarly, pooled RR for stroke decreased up to a potassium intake of around 90 mmol/day (RR 0.67, 95% CI 0.57–0.78). However, the trend was reversed above this cut point. In stratified analysis according to stroke subtype, based on considerably fewer cases, a linear dose–response relation was confirmed up to around 90 mmol/day of potassium intake, while little evidence of an increased risk at higher levels of intake emerged in both the BP‐adjusted and unadjusted analyses (Figure S4). Finally, the various sensitivity analyses we performed on this dose–response relation had little effect on the results (data not shown).


Meta ‐ Analysis of Potassium Intake and the Risk of Stroke
Pooled dose–response association between potassium intake and risk of stroke (solid line) in a meta‐analysis modeling potassium intake with restricted cubic splines in a multivariate random‐effects model, with (A) and without (B) adjustment for blood pressure. The relative risks are plotted on the log scale, with 25 mmol of daily potassium intake serving as referent category. Dashed lines represent the 95% CI for the spline model.
© Copyright Policy - creativeCommonsBy-nc-nd
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5121516&req=5

jah31793-fig-0006: Pooled dose–response association between potassium intake and risk of stroke (solid line) in a meta‐analysis modeling potassium intake with restricted cubic splines in a multivariate random‐effects model, with (A) and without (B) adjustment for blood pressure. The relative risks are plotted on the log scale, with 25 mmol of daily potassium intake serving as referent category. Dashed lines represent the 95% CI for the spline model.
Mentions: In spline regression analysis (Figure 6A), we observed a decrease in the pooled RR up to around 90 mmol/day potassium intake (≈3500 mg/day), based on the most adjusted model. At this cut point of intake, the RR was 0.78 (95% CI 0.70–0.86), while above it the RR flattened and if any slightly increased above 130 mmol/day, though there was substantial uncertainty in this upper range of the distribution. Based on RRs not adjusted for blood pressure, a U‐shaped dose–response curve was observed (Figure 6B). Similarly, pooled RR for stroke decreased up to a potassium intake of around 90 mmol/day (RR 0.67, 95% CI 0.57–0.78). However, the trend was reversed above this cut point. In stratified analysis according to stroke subtype, based on considerably fewer cases, a linear dose–response relation was confirmed up to around 90 mmol/day of potassium intake, while little evidence of an increased risk at higher levels of intake emerged in both the BP‐adjusted and unadjusted analyses (Figure S4). Finally, the various sensitivity analyses we performed on this dose–response relation had little effect on the results (data not shown).

View Article: PubMed Central - PubMed

ABSTRACT

Background: The possibility that lifestyle factors such as diet, specifically potassium intake, may modify the risk of stroke has been suggested by several observational cohort studies, including some recent reports. We performed a systematic review and meta‐analysis of existing studies and assessed the dose–response relation between potassium intake and stroke risk.

Methods and results: We reviewed the observational cohort studies addressing the relation between potassium intake, and incidence or mortality of total stroke or stroke subtypes published through August 6, 2016. We carried out a meta‐analysis of 16 cohort studies based on the relative risk (RR) of stroke comparing the highest versus lowest intake categories. We also plotted a pooled dose–response curve of RR of stroke according to potassium intake. Analyses were performed with and without adjustment for blood pressure. Relative to the lowest category of potassium intake, the highest category of potassium intake was associated with a 13% reduced risk of stroke (RR=0.87, 95% CI 0.80–0.94) in the blood pressure–adjusted analysis. Summary RRs tended to decrease when original estimates were unadjusted for blood pressure. Analysis for stroke subtypes yielded comparable results. In the spline analysis, the pooled RR was lowest at 90 mmol of potassium daily intake (RRs=0.78, 95% CI 0.70–0.86) in blood pressure–adjusted analysis, and 0.67 (95% CI 0.57–0.78) in unadjusted analysis.

Conclusions: Overall, this dose–response meta‐analysis confirms the inverse association between potassium intake and stroke risk, with potassium intake of 90 mmol (≈3500 mg)/day associated with the lowest risk of stroke.

No MeSH data available.


Related in: MedlinePlus