Sacks FM, Brown LE, Appel L, Borhani NO, Evans D, Whelton P
Combinations of potassium, calcium, and magnesium supplements in hypertension

Hypertension (Dec) 26:950-956 1995

There is substantial evidence that potassium supplementation, especially in the form of bicarbonate, lowers blood pressure. The effect of calcium supplementation is somewhat more controversial, and possibly of lesser magnitude, whereas the role for magnesium supplementation is unknown. Using an interventional design, Sacks et al compared BP in 4 ggroups: placebo, 60 mmol KCl/day + 1 g/day Ca (as carbonate), and KCl + 360 mg/day Mg (as diglycine), and calcium + magnesium without KCl. Total initial sample size was 140 patients, with BP after placebo run-in of 85-99 mm Hg diastolic. Patients were studied for 6 months. Salt intake was not restricted. 67% were white.

None of the ion supplementation regimes significantly lowered blood pressure compared to placebo. In fact, the group supplemented with calcium + magnesium and not given KCl had a lesser decline in BP compared to placebo. The conclusion of the study is that none of the ion supplementation combinations are of substantial benefit to lowering BP.

Comment: There are a number of possible explanations as to why ion supplementation did not work in this study: The baseline BP was not very elevated. KCl as opposed to KHCO3 was given. The patients' mean baseline Ca intake was already reasonably high (780 mg/day). Nevertheless, the results do suggest that one should be cautious about prescribing ion supplementation routinely to hypertensive patients in the hopes of achieving a significant reduction in blood pressure. (Daugirdas)

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H: Non drug therapy : Dietary/electrolyte therapy