Eating less salt has long been one of the most familiar pieces of advice for people with high blood pressure.
But scientists say there may be another important part of the story. Getting more potassium could work alongside sodium reduction and make dietary changes more effective.
A new report published in The American Journal of Clinical Nutrition argues that public health advice should give greater attention to both minerals. The authors say sodium reduction remains essential, but many people are also eating far less potassium than may be ideal for healthy blood pressure.
Blood pressure measures the force of blood pushing against the walls of the arteries. When that pressure stays too high for years, it can slowly injure blood vessels and organs. The condition is especially dangerous because people can have hypertension for a long time without feeling ill.
More than 1.28 billion adults worldwide are estimated to have high blood pressure. It is one of the most important preventable contributors to cardiovascular disease, including heart attack and stroke. Diet is only one part of hypertension, but it is one of the factors people can change.
Salt has received much of the attention because ordinary table salt contains sodium. Sodium helps the body control fluids and supports normal nerve and muscle function, so it is not something the body can completely do without. The problem arises when intake is consistently much higher than the body needs.
Modern food environments make this easy to do. Large amounts of sodium can come from bread, sauces, processed meats, snack foods, ready-made meals and restaurant food, sometimes without tasting extremely salty. This has made population-wide sodium reduction surprisingly difficult.
The authors of the new report believe potassium provides another opportunity. Potassium is also an essential mineral, but unlike sodium, many people do not consume enough of it. Good dietary sources include potatoes, beans, lentils, leafy vegetables, fruit, milk and yogurt.
Inside the body, potassium and sodium have closely connected roles. The kidneys help control the amount of both minerals in the bloodstream, and potassium can encourage the removal of sodium in urine. Potassium also helps regulate blood vessel function, which can influence blood pressure.
This means that a diet high in sodium and low in potassium may create a particularly unfavorable situation.
Instead of asking only how much sodium a person eats, researchers increasingly want to understand the balance between the two minerals. Improving that balance could mean lowering sodium while simultaneously raising potassium.
The report, led by Naomi Fukagawa, professor of medicine emerita at the University of Vermont, reviewed current recommendations and evidence surrounding sodium, potassium and blood pressure. It also examined practical ways to change the food supply and discussed questions that future research still needs to answer.
One straightforward strategy is to encourage people to eat more naturally potassium-rich foods. This fits well with broader healthy eating advice because fruits, vegetables and legumes provide many useful nutrients beyond potassium. Replacing heavily processed foods with these foods can also reduce sodium intake at the same time.
Scientists are also interested in potassium chloride as a partial replacement for ordinary sodium chloride. A salt substitute made partly with potassium can achieve two goals at once: it lowers sodium and raises potassium. This could be especially useful because much of the sodium people consume is already added to food before they buy it.
There are practical challenges. Potassium chloride can taste slightly bitter or metallic when used at high levels, so manufacturers cannot simply replace all sodium chloride without affecting taste. Gradual or partial replacement may be a more realistic approach.
Safety also matters. Extra potassium is not suitable for every person, particularly some people with kidney disease or those using medications that interfere with potassium removal. The report’s message therefore should not be interpreted as encouragement for everyone to begin taking potassium supplements.
The strongest practical message is about improving the overall diet rather than chasing a single nutrient. Eating more potassium-rich whole foods while limiting heavily salted and highly processed foods can shift both minerals in a healthier direction.
Other habits, including regular activity, maintaining a healthy weight and following prescribed treatment, remain important for controlling hypertension.
The report is important because it challenges a very narrow way of thinking about blood pressure nutrition. At the same time, it is a perspective based on existing research, not a new experiment proving that a particular sodium-to-potassium target will work for everyone.
More research is still needed to establish the best intake levels and determine how policies work in real-world populations.
Even with those limitations, the proposed change makes biological and practical sense. Rather than treating sodium reduction as the entire dietary solution, health advice may become more useful by asking a second question: are people getting enough potassium-rich foods?
The answer could help shape the next generation of strategies for preventing high blood pressure and protecting heart health.
Source: University of Vermont.
