High Potassium Diet Rich in Spices and Herbs-Salt Substitution (HPSH-SS) for Blood Pressure Reduction in Older Adults: Protocol for Diet Concept and Randomized Controlled Trial (Preprint)

Abstract

UNSTRUCTURED Background: Hypertension prevalence rises with age, primarily linked to dietary factors like high sodium and low potassium intake. Strategies salt reduction and potassium enhancement face taste acceptance challenges, especially among the elderly. The lack of potassium-focused programs hinders its intake despite its crucial role in blood pressure regulation. Phytochemical components in herbs/spices, potentially anti-hypertensive, coupled with potassium content, remain insufficiently explored. While the DASH diet has demonstrated efficacy, its application and study in Indonesia, rich in herbs/spices, remain limited. Objectives: The aims of our research are to analyse the effect of a high-potassium spices/herbs and salt subtitution (HPSH-SS) diet on blood pressure in elderly and to study the molecular mechanism occuring in kidneys and blood vessels influenced by these diets. Methods: This study is a paralel randomized controlled conducted a 14-day dietary intervention on elderly. The research divided subjects into Intervention Groups (IG) receiving a Low Sodium High Potassium (LSHP) diet enriched with spices and herbs, aiming for 3500 mg potassium and 1500 mg sodium daily. The Control Groups (CG) adhered to control diets (1500mg potassium, 2000mg sodium). The primary outcomes of the study include blood pressure assessment; serum potassium, aldosterone, F2 isoprostane, and nitric oxide plasma levels; and sodium and potassium urine levels. Confounding variables, such as age, gender, medication intake, food consumption, and specific health conditions, will be mitigated through randomization and stratified analysis. Discussion: The mechanism of lowering blood pressure by potassium has been widely studied. However, the molecular mechanisms that occur simultant in the kidneys and blood vessels and are related to oxidative stress by giving dietary spices have not been widely studied. Trial registration: Ethical approval was obtained from the Health Research Ethics Committee Universitas Airlangga School of Medicine, Surabaya, Indonesia. (No. 35/EC/KEPK/FKUA/2023) and all subjects provided written consent. Registered on the period February 9, 2023 until February 9, 2024.