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

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. 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. 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. 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.