Dietary Potassium and Blood Pressure.

Abstract

Background: With the rising prevalence of hypertension and the limitations of current treatment and prevention strategies, modifying potassium (K+) intake has emerged as a potential new approach to help control blood pressure (BP). While the renal mechanisms behind the detrimental effects of high salt intake on BP are relatively well described, how and why alterations in dietary K+ can influence BP are less clear. In general, adequate dietary K+ intake appears to be critical for maintaining healthy BP, but specific guidelines for achieving beneficial effects are lacking.

Summary: Interventional trials modifying K+ intake show a general beneficial effect of increasing K+ on BP, predominantly in hypertensive individuals or when sodium (Na+) intake is high. The molecular mechanisms in the kidney, a major site of K+ homeostasis, that contribute to dietary K+ effects on BP have in recent years become clearer. The hypertension associated with low K+ intake is predominantly due to increased activity of the sodium-chloride cotransporter in the distal convoluted tubule. In contrast, the effects of greater K+ intake on BP are not linear and the molecular basis of these diverse responses remains unresolved, but they appear to be interlinked with concurrent Na+ intake. This article briefly covers the major effects of altered K+ intake in humans on BP, then expands on the current knowledge of renal responses to low and high K+ that contribute to these effects.

Key messages: K+ intake is important for BP control, especially when considering Na+ intake or hypertensive status. The renal mechanisms of K+ homeostasis highlight the importance of the urinary Na+/K+ ratio for optimal effects, but key molecular pathways still require investigation.