Researchers argue that current high blood pressure guidelines overlook potassium intake, which deserves equal emphasis with sodium reduction for better blood pressure control.
Naomi Fukagawa, professor of medicine emerita at the Robert Larner College of Medicine at the University of Vermont, led the report published in the American Journal of Clinical Nutrition. The work was supported by the IAFNS Sodium in Food and Health Implications Committee.
High blood pressure affects more than 1.28 billion adults worldwide and is a major risk factor for heart attacks and strokes. While public health recommendations have traditionally focused on cutting sodium, the researchers examined evidence showing that potassium plays an equally important role.
Sodium causes the body to retain fluid, increasing pressure inside blood vessels. Potassium helps counter this by supporting the kidneys in removing excess sodium through urine and contributes to normal blood vessel function.
"It is time to view dietary interventions holistically because food components interact and physiology is integrative across systems," Fukagawa said. "Growing evidence shows that increasing dietary potassium as well as reducing sodium intake work together to better manage hypertension."
Most people consume too much sodium while getting far below optimal potassium levels in both developed and developing nations, according to the authors. Potassium occurs naturally in fruits, vegetables, legumes, and dairy products including bananas, potatoes, beans, leafy greens, and yogurt.
Replacing some sodium chloride with potassium salts in food products could address both goals simultaneously. However, manufacturers face a challenge: too much potassium salt produces an unpleasant metallic taste.
The researchers note that potassium is not appropriate for everyone. People with kidney disease or those taking certain medications may have difficulty regulating potassium levels and should use potassium supplements or salt substitutes only with medical guidance.
The authors conclude that sodium reduction remains essential, but future recommendations should provide equal emphasis on increasing potassium intake alongside reducing sodium.