For decades, advice about high blood pressure has focused heavily on one message: eat less salt.
A new scientific report argues that this approach may be incomplete. Reducing sodium remains important, but increasing potassium at the same time may offer greater benefits for blood pressure and heart health.
High blood pressure, also called hypertension, affects more than 1.28 billion adults around the world. It often causes no obvious symptoms, yet over time it can damage blood vessels and place extra strain on the heart, kidneys and brain.
This is why hypertension is a major risk factor for heart attacks, strokes and other cardiovascular diseases.
Sodium is an essential mineral, but most people need only a relatively small amount. Much of the sodium in modern diets comes from salt added to packaged foods, restaurant meals and processed products. When sodium intake is high, the body can retain more fluid, which can contribute to higher blood pressure in susceptible people.
Public health programs have therefore spent years encouraging people to reduce sodium. However, researchers say another mineral deserves much more attention: potassium. Potassium is found naturally in foods such as fruits, vegetables, beans, lentils and dairy products.
The new report was published in The American Journal of Clinical Nutrition. It was written by Naomi Fukagawa of the University of Vermont and colleagues from several academic, food science and nutrition organizations. Rather than reporting a new clinical trial, the paper is a scientific perspective that reviews existing evidence and considers how public health advice might be improved.
The authors argue that sodium and potassium should not be viewed separately because the two minerals interact inside the body. Potassium helps the kidneys remove sodium and also influences the way blood vessels function. When people eat too little potassium, the blood-pressure effects of a sodium-rich diet may become more important.
This matters because many modern diets have an unfavorable combination: too much sodium and too little potassium. While sodium consumption commonly remains above recommended levels, potassium intake is often well below recommended amounts. The researchers believe improving both sides of this balance could produce better results than concentrating on sodium alone.
One practical approach is simply to eat more foods naturally rich in potassium. Vegetables, fruits, legumes and dairy foods can all contribute meaningful amounts. This approach has an additional advantage because many of these foods also provide fiber, vitamins and other nutrients that support general health.
Another possibility involves replacing part of the sodium chloride in salt with potassium chloride. Potassium-based salt substitutes can reduce the amount of sodium people consume while increasing potassium at the same time. Previous research has suggested that such substitutes can help lower blood pressure and may reduce cardiovascular risk in some populations.
There are limits, however. Potassium chloride can develop a metallic taste when too much is added to food, so manufacturers need to find a balance that people will accept. Food companies may therefore be able to replace only part of the sodium in many products without noticeably changing their flavor.
Increasing potassium is also not appropriate for everyone. People with certain kidney problems or people taking medicines that raise potassium levels may be at risk if they consume too much. For these individuals, major dietary changes or potassium-based salt substitutes should be discussed with a healthcare professional.
The report also points to a larger problem with nutrition advice. Focusing on a single nutrient can sometimes overlook the way different parts of the diet work together.
Blood pressure is influenced not only by sodium and potassium, but also by body weight, physical activity, alcohol intake, overall diet, genetics, age and medical conditions.
The researchers therefore call for a broader public health strategy. Sodium reduction would remain a central goal, but it would be paired with efforts to increase potassium through healthier foods and carefully designed salt substitutes. Food manufacturers, governments, healthcare professionals and consumers could all play a role.
The report offers a useful change in emphasis, but its conclusions should be interpreted carefully.
It is a review and perspective article rather than a new randomized clinical trial, so it does not prove that every person with hypertension will achieve better blood pressure simply by eating more potassium. The ideal amount of potassium may also differ among individuals.
Still, the underlying message is supported by a growing body of research: the balance between sodium and potassium may matter more than focusing on salt alone.
For many people, eating fewer highly salted foods while eating more vegetables, fruits and legumes could improve that balance naturally.
The new report suggests that this two-part strategy deserves a larger place in efforts to prevent and manage high blood pressure.
