Higher Potassium Intake Linked to Lower Cardiovascular Risk in Diabetes, reveals research

The study aimed to examine the association of estimated potassium intake with the risk of MACE among patients with type 2 diabetes. The focus was on the determination of whether higher potassium intake could independently lower the risk of cardiovascular events.

The research comprised a discovery cohort of 1572 patients from a secondary hospital and a validation cohort of 1430 patients from the Chronic Renal Insufficiency Cohort (CRIC). Potassium intake was assessed by separate methods: application of the Kawasaki formula to the discovery cohort and 24 hour urine collection on the validation cohort. MACE was the key outcome, meaning myocardial infarction, stroke, and death from cardiovascular reasons. The people were stratified by levels of albuminuria, measured through the urine albumin-to-creatinine ratio (UACR) for possible interaction.

Key Results

Discovery Cohort Results:

• 341 MACE during a median 8.2 years of follow-up.

• Participants with the highest tertile of potassium intake had 34% lower risk of MACE than the lowest tertile, aHR (95% CI), 0.66 (0.49–0.89).

• The protective effect of potassium intake was more pronounced in participants with normal or moderately elevated albuminuria than in those with severely elevated albuminuria (UACR >300 mg/g, p<0.05).

Validation Cohort Results (CRIC):

• Higher potassium intake was independently associated with a 39% reduced risk of MACE among participants with diabetes and moderately elevated albuminuria (aHR [95% CI], 0.61 [0.42–0.90], top vs. lowest tertile).

• The consistency across both cohorts supports the reliability of the findings.

Albuminuria Interaction:

• The study showed that the benefits of higher potassium intake were significantly affected by albuminuria levels, highlighting its role in modulating cardiovascular risk.

A higher potassium intake, as estimated from urinary potassium excretion, was independently associated with a lower risk of MACE in patients with type 2 diabetes. These findings suggest that dietary strategies to increase potassium intake could provide significant cardiovascular protection, particularly in those with normal or moderately elevated albuminuria.

Reference:

Liu JJ, Zheng H, Liu S, Kwan TK, Gurung RL, Chan C, Lee J, Ang K, de Keizer J, Hadjadj S, Saulnier PJ, Chong MFF, Lim SC. Estimated potassium intake and major adverse cardiovascular events in individuals with type 2 diabetes: a prospective cohort study with trans-ethnic validation. Cardiovasc Diabetol. 2024 Dec 21;23(1):451. doi: 10.1186/s12933-024-02546-y. PMID: 39709437; PMCID: PMC11662727.