Potassium diet has been associated with a lower risk of stroke, but there are few data on the effects of dietary potassium and potassium rich foods on different subtypes of stroke in elderly women with hypertension versus non-hypertension. A multidisciplinary group of physicians and scientists from the Department of Epidemiology and Population Health at the Albert Einstein College of Medicine, Warren Alpert Medical School of Brown University, University of Minnesota, Minneapolis, Fred Hutchinson Cancer Research Center in Seattlee, and Northwestern University Feinberg School of Medicine, Chicago studied a population of over 90,000 post-menopausal women aged 50-79 at enrollment. They were followed prospectively for a mean of eleven years. Incidence was compared across quartiles of intake of potassium in their diet, and risk ratios obtained from models of Cox proportional hazards. Potassium intake in the average diet was 2,600 mg per day. Higher potassium intake quartile was associated with a lower incidence of ischemic and hemorrhagic stroke and total mortality. Multivariate analyzes comparing highest to lowest percentage of potassium intake indicates a relative risk of 0.91 for all-cause mortality, 0, 89 for all times, and 0.85 for ischemic stroke. The effect on ischemic stroke was more evident in women with non-hypertension among which there was a risk 28% lower relative risk of 0.73. There was no association with hemorrhagic stroke. The epidemiologists concludded that the high potassium intake is associated with a lower risk of all stroke and ischemic stroke and all-cause mortality in elderly women, especially those who do not have arterial hypertension. The optimal range of sodium and potassium intake on cardiovascular health remains controversial. Physicians and scientists from Canadian Institutes of Health Research collected urine samples from 102,000 people in 17 countries and 24 hours potassium and sodium excretion was estimated. They sought to relate the association between urinary sodium and potassium excretion and the combined outcome of death and major cardiovascular events. The estimated average sodium and potassium excretion per day was 4.92 gr and 2.13 gr per day, respectively. With a mean follow up of 3.8 years, the composite outcome occurred in 3,317 participants (3%). Compared to an estimated sodium excretion from 4.01 to 6.00 gr per day, sodium excretion estimated higher (> / = 7.01 gr per day) was associated with a higher risk results (odds ratio compound, and an increased risk of death and major cardiovascular events considered separately. The association between a high estimate excretion of sodium and composite outcome was stronger among participants with hypertension with an increased risk to sodium excretion estimated 6.01 gr or more per day. Compared with reference values, estimated sodium excretion was below 3.01 gr per day is also associated with increased risk that the result compound. Compared to an estimated potassium excretion was less than 1.51 gr per day, plus potassium excretion was associated with a reduced risk of the composite outcome. The authors of the study determined that the sodium intake was estimated based on urinary excretion at 3 gr per day. At 6 gr per day it was associated with a lower risk of cardiovascular events and death It was either above or below the estimated level of intake. Compared to an estimated potassium excretion of 1.51 gr per day. Potassium excretion was associated with a lower risk of death and cardiovascular events.
Hypokalemia is frequently seen in daily clinical practice in a pediatric cardiac intensive care unit (PCICU). It is a strong independent predictor of mortality in patients with heart failure. Therefore, a fast potassium replacement therapy is of fundamental importance in the treatment of hypokalemia. Although intravenous potassium replacement (IVPR) due to hypokalemia is the preferred route in most intensive care settings, associated with known security risks and can lead to arrhythmias, cardiac arrest and death if administered inappropriately. Enteral potassium replacement (EPR) with its superior safety profile, may be a better alternative to IVPR. The primary outcome IVPR compare the efficacy and RPE for the treatment of hypokalemia. The secondary outcome measures include a comparison of adverse effects (hyperkalemia, diarrhea, gastrointestinal bleeding, nausea and vomiting) after RPE and IVPR and a comparison of the number of doses is required to achieve resolution of hypokalemia per episode hypokalemia. The Enteral Versus Intravenous Potassium additional trial was designed as a randomized controlled trial, not blinded, with both arms by physicians at the Aga Khan University (Karachi, Pakistan). Intervention arms will be blogging at random alternate weeks for IVPR and EPR. Recruited patients receive treatment accordingly. For analysis, we use the percentage change in the levels of serum potassium in mEq/L after each event of replacement of potassium in both arms as an end point to compare the efficacy and RPE for the treatment IVPR of hypokalemia.
The optimal range of sodium intake with respect to cardiovascular health remains controversial. The Canadian and multinational scientists from 17 countries obtained morning fasting urine samples from 101,945 people (24-hour sodium and potassium excretion). They examined the association between urinary Na+ and K+ excretion and the relationship with respect to outcome (death) and major cardiovascular events. Estimated average sodium and potassium excretion was 4.93 gr and 2.12 gr per day, respectively. With a mean follow-up of 3.7 years, the composite outcome occurred in 3,317 participants. As compared with an estimated sodium excretion of 4 - 6 gr per day, a higher estimated sodium excretion (>/= 7 gr per day) was associated with an increased risk of the composite outcome, as well as increased risks of death and major cardiovascular events considered separately. The association between a high estimated sodium excretion and the composite outcome was strongest among participants with hypertension, with an increased risk at an estimated sodium excretion of 6 gr or more per day. As compared with the reference range, an estimated sodium excretion that was below 3 gr per day was also associated with an increased risk of the composite outcome. As compared with an estimated potassium excretion that was less than 1.50 gr per day, higher potassium excretion was associated with a reduced risk of the composite outcome. In this study in which sodium intake was estimated on the basis of measured urinary excretion, an estimated sodium intake between 3 gr per day and 6 gr per day was associated with a lower risk of death and cardiovascular events than was either a higher or lower estimated level of intake. As compared with an estimated potassium excretion that was less than 1.50 gr per day, higher potassium excretion was associated with a lower risk of death and cardiovascular events.