Dietary potassium: a key mediator of the cardiovascular response to dietary sodium chloride

Abstract

Potassium and sodium share a yin/yang relationship in the regulation of blood pressure (BP). BP is directly associated with the total body sodium and negatively correlated with the total body potassium. Epidemiologic, experimental, and clinical studies have shown that potassium is a significant regulator of BP and further improves cardiovascular outcomes. Hypertensive cardiovascular damage, stroke, and stroke-related death are accelerated by salt intake but might be curbed by increasing dietary potassium intake. The antihypertensive effect of potassium supplementation appears to occur through several mechanisms that include regulation of vascular sensitivity to catecholamines, promotion of natriuresis, limiting plasma renin activity, and improving endothelial function. In the absence of chronic kidney disease, the combined evidence suggests that a diet rich in potassium content serves a vasculoprotective function, particularly in the setting of salt-sensitive hypertension and prehypertension.

Keywords: Blood pressure; dietary potassium; endothelium; sodium chloride.

Figure 1

Effect of potassium supplementation on prevention of cardiovascular event rates. A long-term benefit of potassium supplementation on cardiovascular mortality was observed. Figure adapted from Chang, et al., Am. J. Clin. Nutr. 83:1289, 2006, with permission.