Potassium

Diagnosis and Management of Resistant Hypertension: A Review.

Azizi M, Vongpatanasin W, Fisher NDL, Mahfoud F, Amar L, Kirtane AJ · JAMA · 2026 · n=331

Hypertension, defined as office systolic blood pressure (SBP) 130 mm Hg or greater and/or diastolic blood pressure 80 mm Hg or greater, affects 43.9% of women and 49.5% of men in the US. Approximately 19.7% of patients treated for hypertension have apparent resistant hypertension (blood pressure ≥130/80 mm Hg) despite using 3 or more antihypertensive medications, preferably a renin-angiotensin system blocker, a calcium channel blocker, and a thiazide-type diuretic, at maximally tolerated doses. Approximately 10% of patients treated for hypertension have true resistant hypertension confirmed with home or 24-hour ambulatory blood pressure monitoring to exclude white-coat hypertension (approximately 37.5% of apparent resistant hypertension) and after excluding medication nonadherence (approximately 50%) and secondary hypertension such as primary aldosteronism (approximately 5%-25%). Conditions associated with resistant hypertension include obesity, diabetes, chronic kidney disease

Dietary and Physical Activity Approaches to the Management of High Blood Pressure.

Whelton PK, Vinceti M, Filippini T · Current atherosclerosis reports · 2025

We appraise recent clinical trials, cohort studies, and meta-analyses on dietary and physical activity interventions for prevention and management of high blood pressure. We identified several notable new findings. Using a new statistical model for estimation of treatment dose-response patterns, potassium supplementation demonstrated a U-curve relationship, in contrast to the linear association for other exposures studied. Recent salt substitute reports document substantial BP lowering and prevention of cardiovascular and all-cause mortality. A large and statistically powerful alcohol dose-response meta-analysis of prospective cohort studies suggests there is no beneficial or safe level for alcohol consumption. Finally, large meta-analyses suggest isometric resistance exercise has substantial capacity to lower BP. A major area of uncertainty remains how best to implement the desired dietary and physical activity interventions. In addition to confirming and expanding core knowledge for

Dietary Approaches to Stop Hypertension (DASH) for the primary and secondary prevention of cardiovascular diseases.

Bensaaud A, Seery S, Gibson I, Jones J, Flaherty G, McEvoy JW · The Cochrane database of systematic reviews · 2025 · n=1397

The Dietary Approaches to Stop Hypertension (DASH) diet is designed to lower blood pressure and improve cardiovascular health by reducing sodium and unhealthy fats while increasing nutrients, including potassium, calcium, magnesium, and fibre. While evidence supports its benefits for managing cardiovascular risk factors, gaps remain in understanding its long-term impact on preventing cardiovascular disease (CVD), particularly in terms of hard clinical outcomes such as myocardial infarction and stroke. To assess the effects of the DASH diet for the primary and secondary prevention of cardiovascular diseases. We used standard extensive Cochrane search methods. The latest search date was in May 2024. We included randomised controlled trials (RCTs) comparing a DASH diet intervention to no intervention (including usual care), minimal intervention, or other dietary interventions. In the context of this review, 'minimal intervention' includes brief dietary advice or informational leaflets

[The importance of nutrition in the prevention of endometriosis - Systematic review].

Zaragoza-Martí A, Cabrera-González K, Martín-Manchado L, Moya-Yeste AM, Sánchez-Sansegundo M, Hurtado-Sánchez JA · Nutricion hospitalaria · 2024

Background and objective: endometriosis is a hormone-dependent disorder characterized by the presence of endometrial-like tissue in extrauterine sites, which can trigger a chronic inflammatory reaction. This disease mainly affects women of childbearing age and can have a negative impact on their physical, mental and social well-being. There are eating patterns considered as anti-inflammatory, such as the Mediterranean diet, which could help in the prevention and treatment of endometriosis. The objective of this review was to know the relationship between the consumption of different food groups and the prevention of endometriosis. Materials and methods: a systematic review was carried out following the PRISMA methodology. PubMed, Scopus, Cochrane Library and Web of Science databases were consulted. Studies published between 2013 and 2023 were selected, accessible in full text, written in English and Spanish and including a sample of women with endometriosis and/or healthy women, in add

Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension.

Fu J, Liu Y, Zhang L, Zhou L, Li D, Quan H · Journal of the American Heart Association · 2020 · n=923

Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta-analyses. It is still unclear which intervention would be most efficacious. Methods and Results Bayesian network meta-analyses were performed to estimate the comparative effectiveness of different interventions for lowering BP. From 60 166 potentially relevant articles, 120 eligible articles (14 923 participants) with a median follow-up of 12 weeks, assessing 22 nonpharmacologic interventions, were included. According to the surface under the cumulative ranking probabilities and Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence, for adults with prehypertension to established hypertension, high-quality evidence indicated that the Dietary Approach to Stop Hypertension (DASH) was superior to usual care and all other nonpharmacologic interventions in lowering

Renal Association Clinical Practice Guideline on Haemodialysis.

Ashby D, Borman N, Burton J, Corbett R, Davenport A, Farrington K · BMC nephrology · 2019

This guideline is written primarily for doctors and nurses working in dialysis units and related areas of medicine in the UK, and is an update of a previous version written in 2009. It aims to provide guidance on how to look after patients and how to run dialysis units, and provides standards which units should in general aim to achieve. We would not advise patients to interpret the guideline as a rulebook, but perhaps to answer the question: "what does good quality haemodialysis look like?"The guideline is split into sections: each begins with a few statements which are graded by strength (1 is a firm recommendation, 2 is more like a sensible suggestion), and the type of research available to back up the statement, ranging from A (good quality trials so we are pretty sure this is right) to D (more like the opinion of experts than known for sure). After the statements there is a short summary explaining why we think this, often including a discussion of some of the most helpful researc

Randomized Trial to Assess the Safety and Tolerability of Daily Intake of an Allulose Amino Acid-Based Hydration Beverage in Men and Women.

Bloomer RJ, Pence J, Hellenbrand J, Davis A, Davis S, Stockton M · Nutrients · 2024 · n=40

Maintaining adequate hydration is critical to optimal health, well-being, and performance. Those who are physically active in stressful environments, such as warm and/or humid scenarios, may be at particular risk for dehydration with ensuing loss of electrolytes, leading to sluggishness and impaired physical performance. We evaluated an electrolyte and amino acid product containing L-alanine and L-glutamine, as well as select vitamins [B3 (niacin), B5 (pantothenic acid), B6 (pyridoxine), B12 (cobalamin), and vitamin C (ascorbic acid)]. Subjects (n = 40; four groups, n = 10) were randomized to consume either a placebo packet or one, two, or three packets daily of the test product for 4 weeks with site visits at 0, 2, and 4 weeks. We tested safety and tolerability by analyzing hematological parameters (complete blood counts), metabolic parameters (hepatic, renal, acid-base balance), urinalysis end products, thyroid status [T3 (triiodothyronine), T4 (thyroxine), TSH (thyroid-stimulating

Management of urinary stones by experts in stone disease (ESD 2025).

Papatsoris A, Geavlete B, Radavoi GD, Alameedee M, Almusafer M, Ather MH · Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica · 2025

The formation of kidney stones is a complex biologic process involving interactions among genetic, anatomic, dietary, and environmental factors. Traditional lithogenic models were based on urine supersaturation in relation to the activity of crystallization promoters and inhibitors. However, modern research has added new principles such as the "renal epithelial cell response" and the role of inflammation and oxidative stress leading to the development of a "multi-hit hypothesis". A strong correlation between urinary stones and kidney damage has been well demonstrated by both cohort and case-control studies. The main contributors to chronic kidney damage associated with urinary stones include crystal deposition within the renal parenchyma, associated comorbidities, repeated obstructive and infectious episodes, as well as the potential adverse effects of stone removal procedures. Most hereditary stones may cause high urinary saturation levels promoting obstruction of the Bellini ducts an

The association between dietary mineral intake and bone mineral density: a cross-sectional study.

Wei M, Wei J, Huang S · Journal of health, population, and nutrition · 2025

Minerals are essential for maintaining bone health; however, the relationship between specific mineral intakes and bone mineral density (BMD) remains insufficiently understood. This study aims to examine the associations between the intakes of dietary minerals, including calcium (Ca), phosphorus (P), magnesium (Mg), iron (Fe), zinc (Zn), copper (Cu), sodium (Na), potassium (K), and selenium (Se), and BMD. A cross-sectional study was conducted using data from the National Health and Nutrition Examination Survey (NHANES). Multivariate weighted generalized linear regression and smooth curve fitting were applied to evaluate the associations between dietary mineral intakes and BMD. Furthermore, subgroup analyses and interaction tests were performed to assess the consistency of these associations across different individual characteristics. A total of 11,520 representative adult participants were included in the study. Tertile-based categorical analysis revealed significant positive correl

Association of Vitamins and Minerals with Type 1 Diabetes Risk: A Mendelian Randomization Study.

Shi L, Belbellaj W, Manousaki D · Nutrients · 2025

Background/Objectives: Previous studies suggest that nutrient deficiencies can alter immune responses in animals. However, the impact of micronutrients on autoimmune diseases like type 1 diabetes (T1D) in humans remains unclear since the described associations are based on observational data and they cannot establish causality. This study aims to examine the causal relationship between various micronutrients and T1D using Mendelian randomization (MR). Methods: We performed a two-sample MR analysis using genetic variants from genome-wide association studies (GWASs) of 17 micronutrients as instrumental variables (IVs). We analyzed T1D GWAS datasets of European (18,942 cases/520,580controls), multi-ancestry (25,717 cases/583,311 controls), Latin American/Hispanic (2295 cases/55,134 controls), African American/Afro-Caribbean (6451 cases/109,410 controls), and East Asian (1219 cases/132,032 controls) ancestries. We applied the inverse variance weighted (IVW) method in our main analysis, and

Nasal Steroids, Irrigation, Oral Antibiotics, and Subgroup Targeting for Effective Management of Acute Sinusitis

n=3720 · NCT06076304 · RECRUITING · RECRUITING

Sinus infections (also called acute rhinosinusitis or ARS) affect about 15% of adults each year, and are one of the top reasons people receive antibiotics in outpatient settings. Since most sinus infections are caused by viruses, many patients who take antibiotics for this condition do not actually benefit. Even though this has decreased over recent years, 70% of people are still prescribed them after a visit for ARS. Our goal is to better understand which patients truly benefit from antibiotics and which other treatment options can help people with sinus infections.

Assessment of L-methionine Supplementation on Urinary pH in Calcium Phosphate Stone Formers

n=15 · NCT07465367 · NOT_YET_RECRUITING · NOT_YET_RECRUITING

Some kidney stones including calcium phosphate and struvite stones form in vary alkaline urine (high pH). Currently available medication for stone prevention, namely citrate supplementation, can lead to even higher pH levels and promote stone formation. Multiple prior studies have looked at ways to acidify the urine to reduce the risk of recurrent stone formation. Ascorbic acid has been evaluated but showed no reduction in urinary pH. Ammonium chloride has shown to be effective but poorly tolerated (GI upset) at higher doses and thus is not recommended. Most recently, citric acid has been investigated but demonstrated no change in pH as compared to placebo. L-methionine is an amino acid which is metabolized to sulfate and hydrogen ions by the liver, thereby conferring an acid load onto the kidney and in theory can reduce the pH. Prior studies have demonstrated effective acidification of the urine in healthy individuals and amongst struvite stone formers. The purpose of this study is to assess the ability of L-methionine to acidify the urine of calcium phosphate stone formers. The study will involved patients abiding by a short term metabolic diet. The diet consists of typical foods (some frozen, some fresh) that have been carefully balanced to match the recommended/optimal amount of calories, protein, fat, sodium and calcium for a specific body weight. After eating this diet for 2 days, patients will begin taking L-methionine. The metabolic diet will then be resumed for 2 days at the end of taking the L-methionine (both taken together). At various times of the study, urine collections will be performed to see whether the urine becomes more acidic as a result of the L-methionine. If applicable, participants will be asked to undergo drug washout, to begin after consenting. If participants are taking Thiazide diuretics including hydrochlorothiazide, Chlorthalidone, and indapamide and alkali medications including potassium citrate, sodium bicarbonate, sodium citrate, and potassium bicarbonate, they will be asked to stop taking them 5 days before Day 1 of the protocol.

Pilot Study of Potassium Supplementation in the Treatment of Rheumatoid Arthritis: a 4-Week, Randomized, Double-Blind, Placebo-Controlled Trial

n=36 · NCT00461448 · COMPLETED · COMPLETED

Rheumatoid arthritis is the paradigmatic immune-mediated inflammatory arthropathy. With respect to rheumatoid arthritis (RA), patients have been described as having inappropriately low spontaneous and stimulated cortisol secretion levels. Serum cortisol levels are decreased in RA patients who are taking prednisolone. Also, in patients RA, of longer duration, glucocorticoid receptor (GR) down-regulation has been reported without any change in cortisol levels. There is a reduced capacity for local reactivation of cortisone to cortisol in RA synovial cells. It is noteworthy that since synthetic glucocorticoids also use same reactivation shuttle (the cortisol-cortisone shuttle), the results also apply to therapeutic glucocorticoids. Glucocorticoids are widely used to treat chronic inflammatory conditions including rheumatoid arthritis. Prednisolone has a greater effect than non-steroidal, anti-inflammatory drugs on joint tenderness and pain, whereas the difference in grip strength was not significant. There are no qualitative differences between the effects of endogenous cortisol and exogenously applied synthetic glucocorticoids, since all effects are transmitted via the same receptor. Cortisol, on the other hand, plays a major role in normal potassium homeostasis. Recent studies have highlighted a role for diet, with suggestions that diets high in caffeine, low in antioxidants and high in red meat may contribute to an increased risk for the development of rheumatoid arthritis. Higher intakes of complex carbohydrates, dietary fiber, magnesium, folic acid, vitamin C and E, carotenoids and other phytochemicals have been shown to offer distinct advantages compared to diets containing meat and other foods of animal origin. The relation of a potassium deficiency to RA is much less well documented. The first person to definitively link potassium with arthritis was DeCoti Marsh. LaCelle, Morgan \& Atwater found that the cells of 50 arthritic patients were 30 to 50% lower than healthy people. Our current clinical trial (clinical trial no NCT00399282) shows that most of patients with RA do not have enough potassium intake. This condition may contribute to a subclinical lower serum cortisol, although there is possibility that cortisol serum levels might be unchanged due to a sufficient "cortisol homeostasis" and "potassium homeostasis".