Vongpatanasin Wanpen, Peri-Okonny Poghni, Velasco Alejandro, Arbique Debbie, Wang Zhongyun, Ravikumar Priya, Adams-Huet Beverly, Moe Orson W, Pak Charles Y C
Cardiology Division Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; Charles and Jane Pak Center of Mineral Metabolism and Clinical Research, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Cardiology Division Hypertension Section, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas.
Am J Cardiol. 2016 Sep 15;118(6):849-853. doi: 10.1016/j.amjcard.2016.06.041. Epub 2016 Jun 28.
Diet rich in fruits, vegetables, and dairy products, known as the Dietary Approaches to Stop Hypertension (DASH) diet, is known to reduce blood pressure (BP) in hypertensive patients. More recently, the DASH diet was shown to reduce oxidative stress in hypertensive and nonhypertensive humans. However, the main nutritional components responsible for these beneficial effects of the DASH diet remain unknown. Because the DASH diet is rich in potassium (K), magnesium (Mg), and alkali, we performed a randomized, double-blinded, placebo-controlled study to compare effects of potassium magnesium citrate (KMgCit), potassium chloride (KCl), and potassium citrate (KCit) to allow dissociation of the three components of K, Mg, and citrate on 24-hour ambulatory BP and urinary 8-isoprostane in hypertensive and prehypertensive subjects, using a randomized crossover design. We found that KCl supplementation for 4 weeks induced a significant reduction in nighttime SBP compared with placebo (116 ± 12 vs 121 ± 15 mm Hg, respectively, p <0.01 vs placebo), whereas KMgCit and KCit had no significant effect in the same subjects (118 ± 11 and 119 ± 13 mm Hg, respectively, p >0.1 vs placebo). In contrast, urinary 8-isoprostane was significantly reduced with KMgCit powder compared with placebo (13.5 ± 5.7 vs 21.1 ± 10.5 ng/mgCr, respectively, p <0.001), whereas KCl and KCit had no effect (21.4 ± 9.1 and 18.3 ± 8.4, respectively, p >0.1 vs placebo). In conclusion, our study demonstrated differential effects of KCl and KMgCit supplementation on BP and the oxidative stress marker in prehypertensive and hypertensive subjects. Clinical significance of the antioxidative effect of KMgCit remains to be determined in future studies.
富含水果、蔬菜和乳制品的饮食,即所谓的终止高血压膳食疗法(DASH饮食),已知可降低高血压患者的血压(BP)。最近,DASH饮食被证明可降低高血压和非高血压人群的氧化应激。然而,DASH饮食产生这些有益作用的主要营养成分仍不清楚。由于DASH饮食富含钾(K)、镁(Mg)和碱,我们进行了一项随机、双盲、安慰剂对照研究,采用随机交叉设计,比较柠檬酸酸钾镁(KMgCit)、氯化钾(KCl)和柠檬酸钾(KCit)对高血压和高血压前期受试者24小时动态血压及尿8-异前列腺素的影响,以区分K、Mg和柠檬酸盐这三种成分的作用。我们发现,与安慰剂相比,补充4周KCl可使夜间收缩压显著降低(分别为116±12与121±15 mmHg,与安慰剂相比p<0.01),而KMgCit和KCit对相同受试者无显著影响(分别为118±11和119±13 mmHg,与安慰剂相比p>0.1)。相反,与安慰剂相比,KMgCit粉末可使尿8-异前列腺素显著降低(分别为13.5±5.7与21.1±10.5 ng/mgCr,p<0.001),而KCl和KCit则无作用(分别为21.4±9.1和18.3±8.4,与安慰剂相比p>0.1)。总之,我们的研究表明,补充KCl和KMgCit对高血压前期和高血压受试者的血压及氧化应激标志物有不同影响。KMgCit抗氧化作用的临床意义仍有待未来研究确定。