Potassium and hypertension
- Norman M Kaplan, MD
Norman M Kaplan, MD
- Editor-in-Chief — Nephrology
- Section Editor — Hypertension
- Clinical Professor of Internal Medicine
- University of Texas Southwestern Medical Center
- David B Mount, MD
David B Mount, MD
- Assistant Professor of Medicine
- Harvard Medical School
A low dietary intake of potassium may increase the blood pressure, and potassium supplementation almost always lowers elevated blood pressure. The data demonstrating these associations, as well as the potential mechanisms, will be reviewed here. The approach to patients who present with concurrent hypertension and hypokalemia, and the clinical features of primary aldosteronism are discussed separately. (See "Diagnosis of primary aldosteronism" and "Pathophysiology and clinical features of primary aldosteronism".)
POTASSIUM INTAKE AND BLOOD PRESSURE
The level of potassium intake can affect blood pressure. The effect varies with the direction (low potassium intake raises the blood pressure and high potassium intake lowers the blood pressure) and magnitude of change in potassium intake.
Low-potassium diet — Low dietary potassium intake (below 40 meq/day [1.5 g/day]) has been associated with an elevation in blood pressure and an increased risk of stroke [1-4], as well as an increase in risk of chronic kidney disease . The following observations are illustrative:
●In two different studies, one in healthy normotensive men  and one in patients with primary hypertension (formerly called essential hypertension) , potassium restriction from a normal intake of 80 to 90 meq/day down to 10 to 18 meq/day led to a statistically significant 4 to 5 mmHg increase in systolic blood pressure. The increase in blood pressure may have been mediated in part by sodium retention.
●In a meta-analysis of 11 cohort studies and nearly 250,000 individuals, a 1.64 g (42 mmol)/day higher potassium intake was associated with a 21 percent lower risk of stroke .
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