Clinical Review

Fortnightly review

Beneficial effects of potassium

BMJ 2001; 323 doi: 10.1136/bmj.323.7311.497 (Published 1 September 2001)
Cite this as: BMJ 2001;323:497

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  1. Feng J He, research fellow,
  2. Graham A MacGregor, professor (g.macgregor@sghms.ac.uk)
  1. Blood Pressure Unit, St George's Hospital Medical School, London SW17 0RE
  1. Correspondence to: G A MacGregor
  • Accepted 28 June 2001

Epidemiological and clinical studies have shown that potassium intake has an important role in regulating blood pressure in both the general population and people with high blood pressure.1 High potassium intake may have other beneficial effects independent of its effect on blood pressure—for example, reducing the risk of stroke,2-4 preventing the development of renal vascular, glomerular, and tubular damage,5 decreasing urinary calcium excretion,6 reducing formation of kidney stones,7 and reducing demineralisation of bone (osteoporosis).8-11 In this article we discuss the evidence for these and other benefits of a high potassium intake.

Summary points

Increasing potassium intake lowers blood pressure in both hypertensive and normotensive people

Increasing potassium intake and reducing sodium intake are additive in lowering blood pressure

High potassium intake reduces the risk of stroke and prevents renal vascular, glomerular, and tubular damage

Increasing potassium intake reduces urinary calcium excretion, which reduces the risk of kidney stones and helps prevent bone demineralisation

Increasing serum potassium concentrations reduces the risk of ventricular arrhythmias in patients with ischaemic heart disease, heart failure, and left ventricular hypertrophy

The best way to increase potassium intake is to eat more fresh fruit and vegetables

Methods

We obtained information on the effects of potassium by conducting a Medline search, reviewing reference lists in original and review articles, and communicating with experts in the respective fields.

Blood pressure

The large international study of electrolytes and blood pressure (Intersalt) showed that potassium intake, as judged by 24 hour urinary potassium excretion, was an important independent determinant of population blood pressure. A 30-45 mmol increase in potassium intake was associated with an average reduction in population systolic blood pressure of 2-3 mm Hg.12 Many clinical trials have shown that increasing potassium intake lowers blood pressure both in people with high blood pressure and, to a lesser …

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