Meta‐Analysis of Potassium Intake and the Risk of Stroke

Abstract

BackgroundThe 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 ResultsWe 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.ConclusionsOverall, 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.

Dietary Intake of Acrylamide and Risk of Breast, Endometrial, and Ovarian Cancers: A Systematic Review and Dose–Response Meta-analysis

“…We also performed a dose-response meta-analysis, implementing the recently-developed one-stage methodology (23,24) that we have applied previously (25)(26)(27), which allows the estimation of RRs across a large range of acrylamide intake alongside with their approximate pointwise 95% CIs.…”

Benefit and risk assessment of increasing potassium intake by replacement of sodium chloride with potassium chloride in industrial food products in Norway

“…In the updated meta-analyses of all prospective studies to date, the combined RR of total stroke was 0.91 (95% CI: 0.88, 0.94) for a 1 g/day increase in potassium intake. Vinceti et al (2016) published a systematic review and dose-response meta-analysis of all studies included in Larsson et al (2011) and those that were published later. They carried out a meta-analysis of 16 cohort studies (involving 19,522 stroke events in 639,440 participants) based on the RR of stroke comparing the highest versus lowest intake categories, and plotted a pooled dose-response curve of RR of stroke according to potassium intake.…”

Diet and primary prevention of stroke: Systematic review and dietary recommendations by the ad hoc Working Group of the Italian Society of Human Nutrition

“…The analysis of stroke subtypes, although including fewer cohorts, confirmed a significant inverse association with ischemic (RR: 0.89; 95% CI Z 0.81e0.97) but not with hemorrhagic stroke (intracerebral hemorrhage: RR: 0.95, 95% CI Z 0.83e1.09; subarachnoid hemorrhage: RR: 1.08, 95% CI Z 0.92e1.27) [48]. More recently, such results have been confirmed in the framework of the Women Health Initiative [51] and by the further meta-analysis by Vinceti and co-workers, which has shown in addition that, even for the risk of hemorrhagic stroke, the inverse relationship with potassium intake is statistically significant provided data unadjusted for blood pressure are used in the calculation [52]. This approach appears to be sound as the rate of hemorrhagic stroke is strongly dependent on blood pressure with consequent risk of over adjustment if adjustment for blood pressure is made.…”