From the Departments of Nutrition (A.A., E.B.R., E.L.G., M.J.S., W.C.W.),
Epidemiology (A.A., E.B.R., M.A.H., M.J.S., W.C.W.), and Health and Social
Behavior (I.K.), Harvard School of Public Health, and the Channing Laboratory,
Department of Medicine, Harvard Medical School and Brigham and Women's
Hospital (E.B.R., E.L.G., M.J.S., W.C.W., I.K.), Boston, Mass.
Background—Animal experiments and
epidemiological studies have suggested that high potassium intake may
reduce the risk of stroke, but the evidence is inconclusive, and the
role of other nutrients in potassium-rich foods remains unknown.
Methods and Results—We examined the association of potassium and
related nutrients with risk of stroke among 43 738 US men, 40 to 75
years old, without diagnosed cardiovascular diseases or
diabetes, who completed a semiquantitative food frequency questionnaire
in 1986. During 8 years of follow-up, 328 strokes (210
ischemic, 70 hemorrhagic, 48 unspecified) were documented. The
multivariate relative risk of stroke of any type for
men in the top fifth of potassium intake (median intake, 4.3 g/d)
versus those in the bottom (median, 2.4 g/d) was 0.62 (95% CI, 0.43,
0.88; P for trend=0.007). Results for ischemic
stroke alone were similar. Intakes of cereal fiber and magnesium, but
not of calcium, were also inversely associated with risk of total
stroke. These inverse associations were all stronger in hypertensive
than normotensive men and were not materially altered by adjustment for
blood pressure levels. Use of potassium supplements was also inversely
related to risk of stroke, particularly among men taking
diuretics (relative risk, 0.36; 95% CI, 0.18, 0.72).
Conclusions—Although these data do not prove a causal
relationship, they are consistent with the hypothesis that
diets rich in potassium, magnesium, and cereal fiber reduce the risk of
stroke, particularly among hypertensive men. Potassium supplements may
also be beneficial, but because of potential risks, use should be
carefully monitored and restricted to men taking potassium-losing
diuretics.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Intake of Potassium, Magnesium, Calcium, and Fiber and Risk of Stroke Among US Men
Key Words: stroke • potassium • magnesium • epidemiology • diet
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