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(Hypertension. 1998;31:131.)
© 1998 American Heart Association, Inc.

Scientific Contributions

Effect on Blood Pressure of Potassium, Calcium, and Magnesium in Women With Low Habitual Intake

Frank M. Sacks; Walter C. Willett; Angela Smith; Lisa E. Brown; Bernard Rosner; Thomas J. Moore

From the Department of Nutrition, Harvard School of Public Health (F.M.S., W.C.W., L.E.B.), and the Channing Laboratory (F.M.S., W.C.W., A.S., L.E.B., B.R.), and Endocrine Hypertension Division (T.J.M.), Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, Mass. Reprint requests to Dr Sacks, Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115.

Abstract—In populations, dietary intakes of potassium, calcium, and magnesium each have been inversely associated with blood pressure. However, most clinical trials in normotensive populations have not found that dietary supplements of these minerals lowered blood pressure. We tested the hypothesis that normotensive persons who have low habitual intake of these minerals would be particularly responsive to supplementation. Three hundred normotensive women in the Nurses Health Study II (mean age, 39 years), whose reported intakes of potassium, calcium, and magnesium were between the 10th and 15th percentiles, received for 16 weeks’ duration daily supplements of either potassium 40 mmol, calcium 30 mmol (1200 mg), magnesium 14 mmol (336 mg), all three minerals together or placebos. At baseline, mean (±SD) 24-hour ambulatory blood pressures were 116±8 and 73±6 mm Hg systolic and diastolic, respectively, and mean dietary intakes of potassium, calcium, and magnesium were 62±20 mmol/d, 638±265 mg/d, and 239±79 mg/d, respectively. The mean differences (with 95% confidence intervals) of the changes in systolic and diastolic blood pressures between the treatment and placebo groups were significant for potassium, -2.0 (-3.7 to -0.3) and -1.7 (-3.0 to -0.4), but not for calcium, -0.6 (-2.2 to 1.0) and -0.7 (-2.0 to 0.6), or for magnesium, -0.9 (-2.6 to 0.8) and -0.7 (-2.2 to 0.8). The administration of calcium and magnesium with potassium did not enhance the effect of potassium alone; and the changes in blood pressure were not significant -1.3 (-3.0 to 0.4) and -0.9 (-2.2 to 0.4). In conclusion, potassium, but not calcium or magnesium supplements, has a modest blood pressure–lowering effect in normotensive persons with low dietary intake. This study strengthens evidence for the importance of potassium for blood pressure regulation in the general population.

Key Words: blood pressure • potassium • calcium • magnesium • diet • blood pressure monitoring, ambulatory

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