{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:39:14Z","timestamp":1793234354109,"version":"4.5.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation Research"],"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>\n                      Potassium-enriched table salt lowers blood pressure (BP) and reduces cardiovascular mortality. Whether these beneficial effects stem from reduced Na\n                      <jats:sup>+<\/jats:sup>\n                      intake, increased K\n                      <jats:sup>+<\/jats:sup>\n                      intake, or both is unknown. We tested the hypothesis that oral potassium chloride (KCl) supplementation lowers body Na\n                      <jats:sup>+<\/jats:sup>\n                      content and BP in patients with essential hypertension (EH) or hyperaldosteronism, independent of salt intake.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      Between February 2024 and February 2025, we conducted a single-arm, prospective, longitudinal study with nonrandomized oral KCl intervention in 40 participants with hypertension. All received personalized (blood K\n                      <jats:sup>+<\/jats:sup>\n                      -adjusted) KCl supplementation (Span-K tablets) for 6 to 9 weeks. After the intervention, participants completed a routine diagnostic workup and were classified with EH or hyperaldosteronism. Primary end point: baseline muscle Na\n                      <jats:sup>+<\/jats:sup>\n                      surplus in hyperaldosteronism. Secondary end point: interventional muscle Na\n                      <jats:sup>+<\/jats:sup>\n                      mobilization and BP reduction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Seventeen participants were diagnosed with EH, and 23 with hyperaldosteronism. At baseline, patients with hyperaldosteronism showed higher muscle Na\n                      <jats:sup>+<\/jats:sup>\n                      content (24.67\u00b12.93 versus 22.48\u00b13.37 mmol\/L tissue volume,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.023; primary end point). Oral KCl increased 24-hour urine K\n                      <jats:sup>+<\/jats:sup>\n                      excretion without altering 24-hour urine Na\n                      <jats:sup>+<\/jats:sup>\n                      . KCl supplementation successfully eliminated the muscle Na\n                      <jats:sup>+<\/jats:sup>\n                      surplus in the hyperaldosteronism group (\u22121.90 mmol\/L tissue volume [CI, \u22123.20 to \u22120.60];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.005; secondary end point), lowered blood Na\n                      <jats:sup>+<\/jats:sup>\n                      \/K\n                      <jats:sup>+<\/jats:sup>\n                      ratios in both groups (EH, \u22125.34 [CI, \u22127.69 to \u22122.99];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =4.6\u00d710\n                      <jats:sup>-5<\/jats:sup>\n                      ; hyperaldosteronism, \u22127.02 [CI, \u22129.04 to \u22125.01];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =2.1\u00d710\n                      <jats:sup>-8<\/jats:sup>\n                      ), and reduced systolic BP (EH, \u22128.33 mm\u2009Hg [CI, \u221214.55 to \u22122.12];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.010; hyperaldosteronism, \u22127.35 mm\u2009Hg [CI, \u221212.69 to \u22122.01];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.008). To account for early study termination, a conservative significance threshold of \u03b1=0.025 was implemented, which all end points crossed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>\n                      Oral KCl supplementation mobilizes intracellular Na\n                      <jats:sup>+<\/jats:sup>\n                      stores, corrects pathological Na\n                      <jats:sup>+<\/jats:sup>\n                      \/K\n                      <jats:sup>+<\/jats:sup>\n                      distribution, and lowers BP across hypertension phenotypes. This safe, targeted approach warrants consideration as a scalable public health strategy for cardiovascular disease prevention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>REGISTRATION:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT06569589.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circresaha.126.329131","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:00:20Z","timestamp":1790586020000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Oral KCl Supplementation Safely Reduces Body Na\n                    <sup>+<\/sup>\n                    Surplus and Blood Pressure"],"prefix":"10.1161","clinical-trial-number":[{"clinical-trial-number":"nct06569589","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7702-1577","authenticated-orcid":true,"given":"Adriana","family":"Marton","sequence":"first","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Department of Internal Medicine 4-Nephrology and Hypertension, Paracelsus Private Medical School Nuremberg, Germany (A.M.)."},{"name":"Institute of Physiology, Paracelsus Private Medical School Salzburg, Austria (A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2143-917X","authenticated-orcid":true,"given":"Hieu T.N.","family":"Tran","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Department of Endocrinology, University Medical Center Ho Chi Minh City, Vietnam (H.T.N.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1761-3888","authenticated-orcid":true,"given":"Norihiko","family":"Morisawa","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7665-2724","authenticated-orcid":true,"given":"Ismail","family":"Osman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6473-4375","authenticated-orcid":true,"given":"Seyed Ehsan","family":"Saffari","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzy Tiing","family":"Lim","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6251-8401","authenticated-orcid":true,"given":"Wan Keat","family":"Yam","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Chuah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0478-9075","authenticated-orcid":true,"given":"Wei 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N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4852-7157","authenticated-orcid":true,"given":"Manfred","family":"Rauh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Erlangen, Germany (M.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-5836","authenticated-orcid":true,"given":"Troy","family":"Puar","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8463-8404","authenticated-orcid":true,"given":"Jens","family":"Titze","sequence":"additional","affiliation":[{"name":"Duke-NUS Medical School, National University Singapore (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Duke University, Durham NC (A.M., H.T.N.T., N.M., S.E.S., T.T.L., W.K.Y., E.F., J.-P.K., T.P., J.T.)."},{"name":"Hamburg Center of Kidney Health, Germany 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