Potassium, magnesium, and calcium: their role in both the cause and treatment of hypertension

Abstract

Despite advances in the prevention and treatment of hypertension over the past decade, hypertension remains an important public health challenge. Recent efforts to reduce the prevalence of hypertension have focused on nonpharmacologic means, specifically diet. An increased intake of minerals such as potassium, magnesium, and calcium by dietary means has been shown in some but not all studies to reduce blood pressure in patients with hypertension. This review will discuss the roles of potassium, magnesium, and calcium in the prevention and treatment of essential hypertension with specific emphasis on clinical trial evidence, mechanism of action, and recommendations for dietary intake of these minerals. A high intake of these minerals through increased consumption of fruits and vegetables may improve blood pressure levels and reduce coronary heart disease and stroke.

Figure 1

Mean systolic and diastolic blood pressure at baseline and during each intervention week, according to diet, for 379 patients with complete sets of weekly blood pressure measurements. Reprinted with permission from Appel et al. ¹⁰

Figure 2

End of feeding blood pressure (BP) control rates (%) by diet and sodium level for Dietary Approaches to Stop Hypertension (DASH)‐ Sodium trial participants who had hypertension (HTN) at baseline (systolic BP >140 mm Hg or diastolic BP >90 mm Hg) and in those who had isolated systolic HTN (ISH) at baseline (systolic BP >140 mm Hg and diastolic BP <90 mm Hg). H indicates higher sodium level (142 mmol/d); I, intermediate sodium level (107 mmol/d); L, lower sodium level (65 mmol/d); ^aBP control was defined as systolic BP <140 mm Hg and diastolic BP <90 mm Hg. ^bP<.01 compared with control diet at higher sodium level; ^cP<.05 compared with DASH diet at higher sodium level. Reprinted with permission from Svetkey et al. ³

Figure 3

Overview of meta‐analyses of studies investigating the blood pressure‐lowering effects of potassium. 25–28 SBP indicates systolic blood pressure; DBP, diastolic blood pressure.