Should we eat more potassium to better control blood pressure in hypertension?
Study Goal
The researchers aimed to review the evidence supporting increased potassium intake for better blood pressure control in essential hypertension and assess its risks in CKD patients.
Results Summary
The study found that increasing potassium intake significantly reduces systolic and diastolic blood pressure, particularly in hypertensive patients and those with high sodium intake. High potassium intake also reduces stroke risk by ~25% but may be risky for CKD stages 3-5 patients, especially diabetics.
Population
Hypertensive patients, subjects with high sodium intake, and CKD patients (stages 1-5).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
increasing potassium intake, either with food products or with supplements | decrease | both systolic and diastolic BP | - | - | significant reductions | #1 |
increasing potassium intake | decrease | both systolic and diastolic BP | patients with hypertension | - | significant reductions | #2 |
increasing potassium intake | decrease | both systolic and diastolic BP | subjects with a very high sodium intake | - | significant reductions | #3 |
high potassium intake | decrease | stroke | - | ∼ 25% | reduces the risk | #4 |
increasing potassium in the diet | decrease | decline of renal function | patients with early chronic kidney disease (CKD) stages | - | may perhaps be beneficial | #5 |
high potassium intake | neutral | - | hypertensive patients with CKD stages 3-5, specifically diabetics | - | may be risky and sometimes even dangerous | #6 |
Changes in lifestyle and nutrition are recommended as the first-step approach to the management of hypertension by all national and international guidelines. Today, when considering nutritional factors in hypertension, almost all the attention is focused on the reduction of salt intake to improve blood pressure (BP) control. Changes in potassium intake are only briefly evoked in guidelines. Few physicians actually think about proposing to eat more foods that are high in potassium (fruits, vegetables, nuts) to better control BP. Yet, during the last 40 years, increasing evidence has accumulated demonstrating that increasing potassium intake, either with food products or with supplements, is associated with significant reductions of both systolic and diastolic BP. The hypotensive effect of potassium is particularly marked in patients with hypertension and in subjects with a very high sodium intake, suggesting that potassium counterbalances the effects of sodium. In addition, several meta-analyses have now confirmed that high potassium intake reduces the risk of stroke by ∼ 25%. Finally, increasing potassium in the diet may perhaps be beneficial for some renal patients, as post hoc analyses have suggested that a high potassium intake may retard the decline of renal function in patients with early chronic kidney disease (CKD) stages. However, high potassium intake may be risky and sometimes even dangerous in hypertensive patients with CKD stages 3-5, specifically diabetics. In this context, however, as the level of evidence remains low, more prospective clinical studies are needed. The goal of this review is to discuss the actual evidence that supports the recommendation to eat more potassium in order to better control BP in essential hypertension and to review the restrictions in CKD patients with hypertension.