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(Stroke. 2001;32:1473.)
© 2001 American Heart Association, Inc.

Original Contributions

Dietary Potassium Intake and Risk of Stroke in US Men and Women

National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study

Lydia A. Bazzano, PhD; Jiang He, MD, PhD; Lorraine G. Ogden, MS; Catherine Loria, PhD; Suma Vupputuri, MPH; Leann Myers, PhD Paul K. Whelton, MD, MSc

From the Departments of Epidemiology (L.A.B., J.H., S.V., P.K.W.) and Biostatistics (L.G.O., L.M.), Tulane University School of Public Health and Tropical Medicine, and the Department of Medicine (J.H., P.K.W.), Tulane University School of Medicine, New Orleans, La, and the National Institutes of Health, National Heart, Lung, and Blood Institute (C.L.), Bethesda, Md.

Background and Purpose—The few prospective studies that have explored the association between dietary intake of potassium and risk of stroke have reported inconsistent findings. This study examines the relationship between dietary potassium intake and the risk of stroke in a representative sample of the US general population.

Methods—Study participants included 9805 US men and women who participated in the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-Up Study. Dietary potassium and total energy intake were estimated at baseline by using a 24-hour dietary recall. Incidence data for stroke and coronary heart disease were obtained from medical records and death certificates.

Results—Over an average of 19 years of follow up, 927 stroke events and 1847 coronary heart disease events were documented. Overall, stroke hazard was significantly different among quartiles of potassium intake (likelihood ratio P=0.03); however, a test of linear trend across quartiles did not reach a customary level of statistical significance (P=0.14). Participants consuming a low potassium diet at baseline (<34.6 mmol potassium per day) experienced a 28% higher hazard of stroke (hazard ratio 1.28, 95% CI 1.11 to 1.47; P<0.001) than other participants, after adjustment for established cardiovascular disease risk factors.

Conclusions—These findings suggest that low dietary potassium intake is associated with an increased risk of stroke. However, the possibility that the association is due to residual confounding cannot be entirely ruled out in this observational study.

Potassium, Stroke, and the Bounds of Epidemiological Studies

National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study

S. Claiborne Johnston, MD, PhD, Guest Editor

Neurovascular Service, University of California, San Francisco

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