Potassium Intake, Stroke, and Cardiovascular Disease A Meta-Analysis of Prospective Studies
Potassium Intake, Stroke, and Cardiovascular Disease A Meta-Analysis of Prospective Studies
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DOI：
10.1016/j.jacc.2010.09.070
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发表时间：
2011-03-08
影响因子：
24
通讯作者：
Strazzullo, Pasquale
中科院分区：
文献类型：
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作者：
D'Elia, Lanfranco;Barba, Gianvincenzo;Strazzullo, Pasquale
目的本研究的目的是评估习惯性钾摄入水平与心血管疾病（CVD）发病率之间的关系。背景前瞻性队列研究评估了习惯性钾摄入与心血管疾病发病率之间的关系，但其结果并不完全一致。方法我们对已发表的前瞻性研究进行了系统检索，没有语言限制（1966年至2009年12月）。入选标准为前瞻性成人人群研究、基线钾摄入量评估、血管事件结局评估和至少4年随访。对于每项研究，提取相对风险（RR）和95%置信区间（CI），并使用随机效应模型进行合并，对方差的倒数进行加权。异质性，发表偏倚，亚组，和荟萃回归分析进行。结果11项研究被确定，提供了15个队列样本，包括247,510名男性和女性参与者（随访5至19年），7,066中风，3,058冠心病（CHD）事件，和2,497总CVD事件。通过24小时饮食回忆（n = 2）、食物频率问卷（n = 6）或24小时尿排泄（n = 3）评估钾摄入量。在汇总分析中，每天摄入1.64克（42 mmol）钾与中风风险降低21%相关（RR：0.79; 95%CI：0.68 - 0.90; p = 0.0007），排除单个队列后，CHD和总CVD风险有降低趋势，具有统计学意义，基于敏感性分析（右：0.93; 95%可信区间：结论高钾膳食摄入量与脑卒中发生率相关，并可能降低冠心病和总心血管病的风险。这些结果支持建议增加富含钾的食物的消费，以预防血管疾病。（J Am科尔心脏病学杂志2011;57：1210-9）（C）美国心脏病学会基金会2011年
Objectives The objective of this study was to assess the relation between the level of habitual potassium intake and the incidence of cardiovascular disease (CVD).Background Prospective cohort studies have evaluated the relationship between habitual potassium intake and incidence of vascular disease, but their results have not been not entirely consistent.Methods We performed a systematic search for prospective studies published, without language restrictions (1966 to December 2009). Criteria for inclusion were prospective adult population study, assessment of baseline potassium intake, assessment of vascular events as outcome, and follow-up of at least 4 years. For each study, relative risks (RRs) and 95% confidence intervals (CIs) were extracted and pooled using a random-effect model, weighted for the inverse of the variance. Heterogeneity, publication bias, subgroup, and meta-regression analyses were performed.Results Eleven studies were identified, providing 15 cohort samples that included 247,510 male and female participants (follow-up 5 to 19 years), 7,066 strokes, 3,058 coronary heart disease (CHD) events, and 2,497 total CVD events. Potassium intake was assessed by 24-h dietary recall (n = 2), food frequency questionnaire (n = 6), or 24-h urinary excretion (n = 3). In the pooled analysis, a 1.64-g (42 mmol) per day higher potassium intake was associated with a 21% lower risk of stroke (RR: 0.79; 95% CI: 0.68 to 0.90; p = 0.0007), with a trend toward lower risk of CHD and total CVD that attained statistical significance after the exclusion of a single cohort, based on sensitivity analysis (RR: 0.93; 95% CI: 0.87 to 0.99; p = 0.03 and RR: 0.74; 95% CI: 0.60 to 0.91; p = 0.0037).Conclusions Higher dietary potassium intake is associated with lower rates of stroke and might also reduce the risk of CHD and total CVD. These results support recommendations for higher consumption of potassium-rich foods to prevent vascular diseases. (J Am Coll Cardiol 2011;57:1210-9) (C) 2011 by the American College of Cardiology Foundation