Effects of potassium chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives

Hypertension. 2010 Mar;55(3):681-8. doi: 10.1161/HYPERTENSIONAHA.109.147488. Epub 2010 Jan 18.


To determine the effects of potassium supplementation on endothelial function, cardiovascular risk factors, and bone turnover and to compare potassium chloride with potassium bicarbonate, we carried out a 12-week randomized, double-blind, placebo-controlled crossover trial in 42 individuals with untreated mildly raised blood pressure. Urinary potassium was 77+/-16, 122+/-25, and 125+/-27 mmol/24 hours after 4 weeks on placebo, potassium chloride, and potassium bicarbonate, respectively. There were no significant differences in office blood pressure among the 3 treatment periods, and only 24-hour and daytime systolic blood pressures were slightly lower with potassium chloride. Compared with placebo, both potassium chloride and potassium bicarbonate significantly improved endothelial function as measured by brachial artery flow-mediated dilatation, increased arterial compliance as assessed by carotid-femoral pulse wave velocity, decreased left ventricular mass, and improved left ventricular diastolic function. There was no significant difference between the 2 potassium salts in these measurements. The study also showed that potassium chloride reduced 24-hour urinary albumin and albumin:creatinine ratio, and potassium bicarbonate decreased 24-hour urinary calcium, calcium:creatinine ratio, and plasma C-terminal cross-linking telopeptide of type 1 collagen significantly. These results demonstrated that an increase in potassium intake had beneficial effects on the cardiovascular system, and potassium bicarbonate may improve bone health. Importantly, these effects were found in individuals who already had a relatively low-salt and high-potassium intake.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / drug therapy
  • Albuminuria / epidemiology
  • Albuminuria / physiopathology
  • Bicarbonates / administration & dosage*
  • Blood Pressure / drug effects
  • Bone Remodeling / drug effects*
  • Bone Remodeling / physiology
  • Brachial Artery / drug effects
  • Brachial Artery / physiology
  • Calcium / urine
  • Cross-Over Studies
  • Endothelium, Vascular / drug effects*
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / drug therapy
  • Hypertrophy, Left Ventricular / epidemiology
  • Hypertrophy, Left Ventricular / physiopathology
  • Male
  • Middle Aged
  • Potassium / urine
  • Potassium Chloride / administration & dosage*
  • Potassium Compounds / administration & dosage*
  • Pulsatile Flow / drug effects
  • Risk Factors
  • Severity of Illness Index
  • Sodium Chloride, Dietary / administration & dosage


  • Bicarbonates
  • Potassium Compounds
  • Sodium Chloride, Dietary
  • Potassium Chloride
  • potassium bicarbonate
  • Potassium
  • Calcium