***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The Trial of Antihypertensive Interventions and Management is a multicenter r and omized trial design ed to examine the diastolic blood pressure response of various combinations of pharmacological and dietary interventions in the treatment of mild hypertension ( diastolic blood pressure 90 - 100 mm Hg ) . Eight hundred and seventy-eight participants at 110 - 160 % of ideal weight were r and omly allocated to nine drug/diet treatment groups receiving either a placebo , chlorthalidone ( 25 mg ) , or atenolol ( 50 mg ) , combined with a usual , a weight loss , or a low sodium/high potassium diet The primary outcome was diastolic blood pressure change from baseline to 6 months . Seven hundred and eighty-seven participants had follow-up data . The mean baseline diastolic blood pressure  was 93.8 mm Hg ; 55.9 % of the participants were male , and the weight loss diet group lost an average of 4.7 kg . Multiple comparisons were accounted for in the analysis . A significantly greater lowering of diastolic blood pressure ( 12.4 mm Hg ) was achieved in the atenolol group compared with either the low sodium/high potassium diet group ( 7.9 mm Hg , p=0.001 ) or weight loss group ( 8.8 mm Hg , p=0.006 ) . Adding weight loss to chlorthalidone significantly enhanced blood pressure lowering ( 15.1 mm Hg ) when compared with the diuretic alone ( 10.8 mm Hg , p=0.002 ) , but adding a low sodium/high potassium diet ( 12.2 mm Hg , p=0.029 ) did not In the short-term treatment of mild hypertension where diastolic blood pressure is the sole consideration , drugs outperform diet , and weight loss is beneficial , especially with diuretics OBJECTIVE To determine whether an increase in dietary potassium intake from natural foods reduces the need for antihypertensive medication in patients with essential hypertension . DESIGN R and omized , controlled trial with 1-year follow-up . SETTING Hypertension outpatient clinic of a university hospital . PATIENTS Fifty-four patients with well-controlled hypertension , 47 of whom completed 1 year of follow-up . INTERVENTION Patients were r and omly assigned to one of two groups and were given dietary advice aim ed at selectively increasing potassium intake ( group 1 ) or at keeping their customary diet unchanged ( group 2 ) . During a 1-year follow-up period , drug therapy was reduced in stepwise fashion , according to a fixed protocol , provided that blood pressure remained below 160/95 mm Hg . MAIN RESULTS Potassium intake was checked monthly by referring to 3-day food records and by measuring 24-hour urinary potassium excretion . Potassium intake increased in group 1 but did not change in group 2 ( P less than 0.001 ) . No change was observed in either urinary sodium excretion or in body weight . After 1 year , the average drug consumption ( number of pills per day ) relative to that at baseline was 24 % in group 1 ( 95 % Cl , 15 % to 32 % ) and 60 % in group 2 ( Cl , 44 % to 76 % ) ( P less than 0.001 ) . By the end of the study , blood pressure could be controlled using less than 50 % of the initial therapy in 81 % of the patients in group 1 ( Cl , 66 % to 96 % ) compared with 29 % of the patients in group 2 ( Cl , 10 % to 48 % ) ( P = 0.001 ) . Patients in group 1 ended the study with a lower number of reported symptoms compared with patients in the control group ( P less than 0.001 ) . CONCLUSION Increasing the dietary potassium intake from natural foods is a feasible and effective measure to reduce antihypertensive drug treatment Phase I of the Trials of Hypertension Prevention ( TOHP ) was a r and omized , multicenter investigation that included double-blind , placebo-controlled testing of calcium and magnesium supplementation among 698 healthy adults ( 10.5 % blacks and 31 % women ) aged 30 to 54 years with high-normal diastolic blood pressure ( DBP ) ( 80 to 89 mm Hg ) . Very high compliance ( 94 to 96 % by pill counts ) with daily doses of 1 g of calcium ( carbonate ) , 360 mg of magnesium ( diglycine ) , or placebos was corroborated for the active supplements by significant net increases in all urine and serum compliance measures in white men and for urine compliance measures in white women . Overall , neither calcium nor magnesium produced significant changes in blood pressure at 3 and 6 months . Analyses stratified by baseline intakes of calcium , magnesium , sodium , or initial blood pressures also showed no effect of supplementation . These analyses suggested that calcium supplementation may have result ed in a DBP decrease in white women and that response modifiers in this subgroup might have included lower initial urinary calcium levels , urinary sodium levels , or lower body mass index . However , overall analyses indicated that calcium and magnesium supplements are unlikely to lower blood pressure in adults with high-normal DBP . The subgroup analyses , useful to formulate hypotheses , raise the possibility of a benefit to white women , which requires testing in future trials Thirty-three patients with hypertension receiving drug treatment that included a potassium losing diuretic were r and omly allocated to 64 mmol of potassium  ( 14 patients ) or to no additional potassium supplementation  ( 19 patients ) . Potassium was administered as slow release potassium chloride . After 3 months , blood pressure fell by 5/1 mm Hg in the patients who received the supplements and by 7/4 mm Hg in those who did not receive them . The falls in pressure were not significantly different and the 90 % confidence limits for the effect of supplementation on diastolic pressure were : a fall of 2 mm Hg and a rise of 11 mm Hg , thus excluding an important hypotensive effect in these patients . Conversely , plasma creatinine fell by 11 % in the supplement group compared with a 6 % rise in the control group ( P less than 0.05 ) . Potassium supplementation , either by pharmacological preparations or by dietary manipulation , may prove to be desirable in patients on a potassium losing diuretic but should not be expected to lower blood pressure in such patients Potassium chloride ( KCl ) salt ( 65 mmol ) daily reduced BP from 153/104 to 146/101 mmHg in 32 hypertensive black females during a 6-week placebo controlled crossover study . The fall in BP was independent of the order of r and omization and was significant for systolic ( SBP ; P less than 0.01 ) and diastolic ( DBP ; P less than 0.05 ) pressure after 4 weeks . Analysis of the 95 % confidence intervals in this and in five other studies , two of which were reported as showing no beneficial effect , suggests that potassium supplementation does lower BP , but that the change is small and within the confidence levels of all six trials . Thus , apparent discrepancies in the literature are not genuine statistically The blood pressure responses of 19 mildly hypertensive ( diastolic blood pressure 90–104 mmHg ) individuals to treatment with either 1200 mg of elemental calcium supplementation or placebo were assessed weekly in a 6-month r and omized , double-blind , placebo-controlled crossover study . Both groups showed a decrease in blood pressure  ( calcium treated : 6 ± 12 mmHg systolic , 7 ± 7 mmHg diastolic ; and placebo controlled : 9 ± 14 mmHg systolic , 9 ± 8 mmHg diastolic ) . Differences between the two groups were not significant ( P > 0.1 ) . There were no adverse effects to either treatment . This study does not support the hypothesis that dietary calcium supplementation is more effective than placebo in reducing blood pressure in mildly hypertensive individuals In a double-blind , placebo-controlled trial with 58 normotensive female students , the effect of oral-calcium supplementation ( 1500 mg Ca++/day for 6 wk ) on diastolic and systolic blood pressure was studied while students were consuming a low-calcium diet ( 500 mg Ca++/day  )  by restricting the intake of dairy products . Results show that , in both the calcium- and placebo-supplemented groups , blood pressure values decreased slightly and no effect of oral-calcium supplementation on blood pressure could be demonstrated . In addition , at baseline neither systolic nor diastolic blood pressure correlated with habitual calcium intake . Diastolic but not systolic blood pressure correlated significantly with body mass index ( r = 0.31 , p = 0.01 ) . It is concluded that oral-calcium supplementation for 6 wk does not influence blood pressure in young , healthy normotensive females consuming low-calcium diet BACKGROUND Total body potassium ( TBK ) is an index of fat-free mass . Data describing changes in TBK in African American , Asian , or Hispanic population s have not been reported . OBJECTIVE The aim was to investigate possible sex and racial differences in TBK in adults over an age range of 70 y. DESIGN The study used longitudinal and cross-sectional data collected in a body-composition unit from 973 men and 1368 women of African American , Asian , white , and Hispanic race-ethnicity . R and om coefficient models in which baseline weight and height were taken into account were applied to estimate sex-specific changes in TBK among the 4 racial-ethnic groups . RESULTS The ages of 30 and 31 y were identified for women and men , respectively , as the cutoffs after which TBK began to decline . Both sexes had similar racial-ethnic patterns for expected mean TBK at the age cutoffs : African Americans had the highest value , followed by whites , Hispanics , and Asians . After the age cutoffs , the decline in TBK differed by race and sex . In women , African Americans showed the most rapid decline , whereas Asians had the lowest . In men , Hispanics had the most rapid decline in TBK , followed by African Americans , whites , and Asians . CONCLUSION Significant sex and racial differences exist in the rate of change in TBK with age . Further studies are needed to explore the associations of declining TBK with health risks OBJECTIVE To determine the effect of potassium supplementation on blood pressure in African Americans consuming a low-potassium diet . DESIGN R and omized , double-blind , placebo-controlled trial with two parallel arms . SETTING Community-based research site . PARTICIPANTS Eighty-seven healthy African Americans aged 27 to 65 years with a systolic blood pressure between 100 and 159 mm Hg and a diastolic blood pressure between 70 and 94 mm Hg . INTERVENTION During the 21-day intervention period , all participants were provided with a low-potassium diet ( 32 to 35 mmol/d ) . In addition to this diet , they were r and omly assigned to receive either potassium supplements ( 80 mmol/d ) or placebo . MAIN OUTCOME MEASURE Change in blood pressure in the potassium vs the placebo group , based on a total of nine blood pressure readings at three visits . Blood pressures were taken before and during the intervention by means of r and om-zero sphygmomanometry . RESULTS At baseline , the placebo and potassium groups were similar for mean blood pressure ( 127/78 vs 125/77 mm Hg ) , 24-hour urinary potassium excretion ( 50 vs 44 mmol ) , and all other variables measured ( all P > .05 ) . During the intervention , the net difference in 24-hour urinary potassium excretion between groups was 70 mmol . Compared with the placebo group , the potassium supplementation group experienced a net decline in systolic blood pressure of 6.9 mm Hg ( 95 % confidence interval , -9.3 to -4.4 mm Hg ; P < .001 ) and a decline in diastolic blood pressure of 2.5 mm Hg ( 95 % confidence interval , -4.3 to -0.8 mm Hg ; P = .004 ) . Simultaneous adjustment for differences in baseline characteristics only strengthened these estimates . CONCLUSIONS Potassium supplementation reduces blood pressure substantially in African Americans consuming a diet low in potassium . Increased potassium intake may play an important role in reducing blood pressure in this population at high risk for hypertension Epidemiological and experimental data suggest blood pressure-lowering effects of dietary potassium . A r and omized , double-blind clinical trial was used to assess blood pressure response to orally administered potassium , 120 mEq/day , and to placebo in 101 adults with mild hypertension .  Blood pressure was measured with a r and om-zero sphygmomanometer every 2 weeks of this 8-week trial . Systolic blood pressure in the potassium-treated group decreased by 6.4 + /- 13.7 ( SD ) mm Hg ( p less than or equal to 0.025 ) compared with 0.11 + /- 13.0 mm Hg in the placebo-treated group ( p = 0.96 ) . Diastolic blood pressure in the pot 
    Output:
    
The substantial heterogeneity between trials was not explained by potassium dose , quality of trials or baseline blood pressure .
This systematic review found no statistically significant effect of potassium supplementation on blood pressure .