Wilson DK, Sica DA, Devens M, Nicholson
The influence of potassium intake on dipper vs. non-dipper
blood pressure status in adolescents
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:146A 1997
Background: Potassium supplementation plays a role in blood
pressure reduction in salt sensitive individuals. This effect has
been shown to be related to the natriuretic properties of increased
potassium intake. Blood pressure has a circadian rhythm where
blood
pressure dips at night. When dipping fails to occur, the emergence
of
hypertension and end-organ damage due to the 24 hour pressure load
tends to be increased. This study addressed the effects of
potassium
supplementation on nighttime blood pressure dipping.
Study Results: Forty subjects (all Afro-American) were
randomized to high (80 mEq/day) or control (usual K) diets
(duration
not given). Dippers were classified as those experiencing a
>10%
decrease in mean blood pressure from the awake to the asleep
periods.
Seventy percent of all subjects studied were dippers. In dippers
daytime blood pressure decreased with potassium supplementation.
In
non-dippers, daytime blood pressure actually INCREASED, and this
increase was largely responsible for a change from non-dipper to
dipper status in 80%, as nighttime BP was unchanged.
Comment: These are interesting and confusing observations.
Non-dipper status is more frequent in this adolescent black
population
as compared to other racial groups. The duration of potassium
supplementation is not given, but potassium did appear to increase
daytime blood pressures in the non-dipper group. The increase in
daytime BP may have been due to an enhanced natriuretic action of
potassium ultimately activating the renin-angiotensin system which
is
most active during the day, but the mechanism remains speculative.
Arlene Chapman, M.D., (University of Colorado, Denver)
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12th Annual ASH Meeting
H: Non drug therapy :
Dietary/electrolyte therapy
H: Diagnosis :
Preadolescent and adolescent