Increases in dietary potassium over a 4-week period do not cause hyperkalemia in hypertensive patients with normal renal function who are receiving ACE inhibitor or angiotensin receptor blocker (ARB) therapy, new findings suggest.

Gary E. Newton, MD, of Sinai Health System and University Health Network in Toronto, and colleagues conducted a 4-week controlled trial involving 20 hypertensive patients treated with an ACE inhibitor or ARB. All had normal renal function. The investigators randomly assigned patients to a usual diet or a high-potassium diet (HKD). HKD patients used fruit and vegetable consumption to increase potassium intake. Serum potassium measurements, 3-day food records, and 24-hour urine collections were obtained at baseline and at 4 weeks.

In the usual-diet group, the investigators observed no statistically significant differences for potassium excretion, intake, or serum levels at the end of the study compared with baseline. The HKD group had a statistically significant increase in urinary potassium excretion (from 83 mmol/day at baseline to 109 mmol/day at 4 weeks) and dietary potassium intake (3775 mg/day at baseline to 5212 mg/day at 4 weeks), Dr Newton and his colleagues reported in the American Journal of Clinical Nutrition (2016;104:990-994).

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Despite increased potassium intake in the HKD group, serum potassium concentrations did not increase significantly from baseline at midpoint or end of study (4.1 vs 4.3 vs 4.2 mmol/L), the investigators reported.

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