钾摄入、中风和心血管疾病：前瞻性研究的荟萃分析。

Potassium intake, stroke, and cardiovascular disease a meta-analysis of prospective studies.

机构信息

Department of Clinical and Experimental Medicine, University of Naples Medical School, Naples, Italy.

出版信息

J Am Coll Cardiol. 2011 Mar 8;57(10):1210-9. doi: 10.1016/j.jacc.2010.09.070.

DOI:10.1016/j.jacc.2010.09.070

PMID:21371638

Abstract

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.

摘要

目的

本研究旨在评估习惯性钾摄入量与心血管疾病（CVD）发病率之间的关系。

背景

前瞻性队列研究已经评估了习惯性钾摄入量与血管疾病发病率之间的关系，但结果并不完全一致。

方法

我们对 1966 年至 2009 年 12 月期间发表的前瞻性研究进行了系统检索，无语言限制。纳入标准为前瞻性成人人群研究、基线钾摄入量评估、血管事件作为结局评估以及至少 4 年的随访。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汇总，权重为方差的倒数。进行了异质性、发表偏倚、亚组和荟萃回归分析。

结果

共确定了 11 项研究，提供了 15 个队列样本，包括 247510 名男性和女性参与者（随访时间为 5 至 19 年）、7066 例卒中、3058 例冠心病（CHD）事件和 2497 例总 CVD 事件。钾摄入量通过 24 小时膳食回忆（n = 2）、食物频率问卷（n = 6）或 24 小时尿排泄（n = 3）进行评估。在汇总分析中，每天摄入 1.64 克（42mmol）钾可使卒中风险降低 21%（RR：0.79；95%CI：0.68 至 0.90；p = 0.0007），CHD 和总 CVD 的风险呈下降趋势，但在根据敏感性分析排除单个队列后，这种趋势具有统计学意义（RR：0.93；95%CI：0.87 至 0.99；p = 0.03 和 RR：0.74；95%CI：0.60 至 0.91；p = 0.0037）。