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Serum potassium and risk of cardiovascular disease: the Framingham heart study
Craig R Walsh1, Martin G Larson, Eric P Leip
1Framingham Heart Study, 5 Thurber St, Framingham, MA 01702, USA.
Insights
Serum potassium levels were not linked to cardiovascular disease risk in a Framingham Heart Study cohort. This research clarifies the relationship between serum potassium and cardiovascular disease incidence in a healthy population.
Area of Science:
- Cardiovascular Medicine
- Clinical Research
- Epidemiology
Background:
- Conflicting findings exist regarding serum potassium and cardiovascular disease (CVD) risk in community populations.
- Previous studies have yielded inconsistent results on the association between serum potassium concentration and CVD risk.
Purpose of the Study:
- To investigate the relationship between serum potassium levels and the risk of developing cardiovascular disease.
- To clarify the association between serum potassium concentration and cardiovascular disease risk within the Framingham Heart Study cohort.
Main Methods:
- Analysis of 3151 participants from the Framingham Heart Study, free of CVD and not on potassium-affecting medications.
- Serum potassium levels were measured between 1979-1983, with follow-up for CVD incidence over 16 years.
- Proportional hazards models were used to assess the association between baseline serum potassium and cardiovascular disease events.
Main Results:
- Initially, serum potassium showed a marginal association with CVD risk after age adjustment (HR 1.03 per 1 mg/dL increment).
- However, after adjusting for multiple confounders, serum potassium levels were not significantly associated with cardiovascular disease risk (HR 1.00).
- No significant association was found between serum potassium levels and CVD-related death in any model.
Conclusions:
- Serum potassium levels are not associated with the risk of developing cardiovascular disease in a community-based sample.
- This study suggests that in individuals without pre-existing CVD and not on relevant medications, serum potassium concentration does not predict future cardiovascular events.
Background:
Published studies of the association between serum potassium concentration and risk for cardiovascular disease in community-based populations have reported conflicting results. We sought to determine the association between serum potassium concentration and cardiovascular disease risk in the Framingham Heart Study.
Methods:
A total of 3151 participants (mean age, 43 years; 48% men) in the Framingham Heart Study who were free of cardiovascular disease and not taking medications affecting potassium homeostasis had serum potassium levels measured (1979-1983). Proportional hazards models were used to determine the association of serum potassium concentration at baseline with the incidence of cardiovascular disease at follow-up.
Results:
During mean follow-up of 16 years, 313 cardiovascular disease events occurred, including 46 cardiovascular disease-related deaths. After adjustment for age, serum potassium level was marginally associated with risk of cardiovascular disease (hazard ratio [HR] per 1 mg/dL increment, 1.03; 95% confidence interval [CI], 1.00-1.05; P =.02). However, after further adjustment for multiple confounders, serum potassium level was not significantly associated with cardiovascular disease risk (HR, 1.00; 95% CI, 0.98-1.03). There were no significant associations between serum potassium level and cardiovascular disease-related death in either age- and sex-adjusted models (HR, 1.06; 95% CI, 0.99-1.12) or multivariable-adjusted models (HR, 1.04; 95% CI, 0.97-1.11).
Conclusion:
In our community-based sample of individuals free of cardiovascular disease and not taking medications that affect potassium homeostasis, serum potassium level was not associated with risk of cardiovascular disease.