• Citation/Abstract
• Dissertation or Thesis

Assessment of Potassium Focused Dietary Strategies in Individuals with Cardiovascular Disease

Malta, Daniela.   University of Toronto (Canada) ProQuest Dissertations Publishing,  2018. 10937372.

Despite the wealth of clinical data investigating the benefits of a high K⁺ intake, there is a lack of knowledge regarding the safety of a high K⁺ diet in individuals that may have disturbances in K⁺ homeostasis. This thesis will focus on both HTN and heart failure (HF) populations as there are several factors common to both that can predispose to hyperkalemia. In addition, the final piece of work will report on the postprandial impact of K⁺ intake in augmenting endothelial function and its subsequent role as a possible mechanism in driving changes in blood pressure.

The overall objectives of this work were to investigate the safety of a high K + diet in individuals that may be at risk for hyperkalemia due to medical management; and to investigate the acute changes in endothelial function after ingestion of a high and low K+ meal.

We determined that: (1) high K⁺ diet did not cause hyperkalemia or any statistically significant or clinically relevant changes in serum K ⁺ in hypertensive individuals receiving angiotensin converting enzyme inhibitors or/and angiotensin receptor blocker therapy; (2) in heart failure patients, despite increases in reported K⁺ consumption and accompanying changes in urinary K⁺ between groups, there were no overall significant changes in serum K⁺ concentrations. However, hyperkalemia occurred in 3 patients: 2 in the HKD group and 1 in the UD group. Based on these results, we cannot confirm the safety of consuming any amount of dietary K⁺ without monitoring serum K ⁺ in patients with HF; (3) A single meal high in K⁺ did not improve endothelial function. This suggests that the beneficial effects of dietary K⁺ may not occur acutely or that a change in one nutrient, like K⁺, was not sufficient to improve FMD, a marker of endothelial function.

In summary, these experiments provide novel information related to the safety of increasing K⁺ intake through K⁺ rich foods in populations at risk for hyperkalemia. This work also gives insight into the postprandial effects of high K⁺ intake on vascular function in a population likely to have endothelial dysfunction due to disease.