Effects of sodium and potassium supplementation on endothelial function and inflammation in untreated (pre)hypertensives: a fully controlled dietary intervention study

L. Gijsbers, J.I. Dower, C.G. Schalkwijk, Y.H.A.M. Kusters, S.J. Bakker, P.C.H. Hollman, J.M. Geleijnse

Research output: Contribution to journalAbstractAcademic


High sodium and low potassium have been associated with detrimental effects on blood pressure. However, the role of these minerals in endothelial dysfunction and low-grade inflammation, which may predispose to cardiovascular disease, has not yet been established. We performed a randomized placebo-controlled crossover study to examine the effects of sodium and potassium supplementation on endothelial function and inflammation in untreated (pre)hypertensive adults.

During the study, subjects were on a fully controlled diet that contained on average 2.4 g of sodium and 2.3 g of potassium per day for a 2500 kcal intake. After one-week run-in, subjects were randomized to ingest capsules with supplemental sodium (3 g/d), supplemental potassium (3 g/d), or placebo, for four weeks each, in random order. After each intervention period, brachial artery flow-mediated dilation, and circulating biomarkers of endothelial function (e.g. nitric oxide, endothelin-1, cellular adhesion molecules) and inflammation (e.g. tumor necrosis factor-α, C-reactive protein, interleukins) were measured.

Of 37 randomized subjects, 36 completed the study. Subjects had a mean pre-treatment blood pressure of 145/81 mmHg. Sodium supplementation increased serum endothelin-1 by 0.24 pg/ml (95% CI: 0.03, 0.45), but had no effect on other endothelial or inflammatory biomarkers, or flow-mediated dilation. Potassium supplementation reduced interleukin-8 levels by 0.28 pg/ml (95% CI: 0.03, 0.53), without affecting other circulating biomarkers. Flow-mediated dilation was 1.16% (95% CI: 0.37, 1.96) higher after potassium supplementation than after placebo, with 83% of the subjects showing an improvement (Figure).

Sodium and potassium supplementation had little impact on circulating endothelial and inflammatory biomarkers, and only for potassium an effect on flow-mediated dilation was observed. This study suggests different actions for sodium and potassium in the pathophysiological processes leading to cardiovascular disease.(Figure is included in full-text article.).
Original languageEnglish
Pages (from-to)e72
Number of pages1
JournalJournal of Hypertension
Issue numberS1
Publication statusPublished - Jun 2015
Event25th European Meeting on Hypertension and Cardiovascular Protection - Milan, Italy, Italy
Duration: 12 Jun 201515 Jun 2015


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