Associations between potassium, arterial stiffness, and risk of cardiovascular disease in the Jackson Heart Study

Background

Potassium (K) measures are associated with cardiovascular disease (CVD) risk factors, particularly blood pressure (BP). Arterial stiffness is a pre-clinical marker of CVD risk. We sought to study associations of K measures with arterial stiffness and CVD risk in a population at high-risk of CVD.

Methods

We studied participants from the Jackson Heart Study (JHS), a longitudinal cohort of adults racially minoritized as Black, who were without CVD at Visit 1 (2000–2004). We compared characteristics between participants with low-normal (lowK) (≤4.0 mmol/L) vs. high-normal (highK) (>4.0 mmol/L) serum K. We used multivariable regression to examine associations of serum and dietary K at Visit 1 with arterial stiffness [brachial artery pulse pressure (PP) and carotid-femoral pulse wave velocity (CFPWV)], measured between 2012 and 2017, incident CVD overall over up to 15 years of follow-up, and individual CVD outcomes.

Results

We included 4035 JHS participants in our analyses; mean age was 54 years, 64 % were female. Participants with highK as compared to lowK had lower mean baseline BP and had reduced arterial stiffness. In adjusted models, higher serum K (per standard deviation increase) was associated with lower CFPWV [estimate (95 % CI) -1.66 (-2.88, -0.44)]. There was a significant difference in cumulative incidence of CVD, with the highK group having lower risk (P = 0.047); however, we did not observe statistically significant associations between serum K and any CVD outcomes after multivariable adjustment. We found no significant associations between dietary K and arterial stiffness or incident CVD.

Conclusions

In this cohort of Black adults, higher serum K was significantly associated with lower arterial stiffness. Further study is needed to assess the relationship between K's association with arterial stiffness and future CVD risk.