Chia Yook-Chin, He Feng J, Cheng Maong-Hui, Shin Jinho, Cheng Hao-Min, Sukonthasarn Apichard, Wang Tzung-Dau, Van Huynh Minh, Buranakitjaroen Peera, Sison Jorge, Siddique Saulat, Turana Yuda, Verma Narsingh, Tay Jam Chin, Schlaich Markus P, Wang Ji-Guang, Kario Kazoumi
Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia.
Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Hypertens Res. 2025 Jan;48(1):301-313. doi: 10.1038/s41440-024-01862-w. Epub 2024 Oct 29.
Cardiovascular diseases (CVD) continue to be the leading cause of deaths and disability worldwide and the major contributor is hypertension. Despite all the improvements in detecting hypertension together with technological advances and affordable, efficacious and relatively free of adverse effects anti-hypertensive agents, we continue to struggle to prevent the onset of hypertension and to control blood pressure (BP) to acceptable targets. The poor control of hypertension is commonly due to non-adherence to medications. Another reason is the failure to adopt diet and lifestyle changes. Reduction of dietary salt intake is important for lowering BP but the role of potassium intake is also important. Globally the intake of sodium is double that of the recommended 2 gm per day (equivalent to 5 gm of sodium chloride/salt) and half that of the daily recommended intake of potassium of 3500 mg/day, giving a sodium-to-potassium ratio of >1, when ideally it should be <1. Many studies have shown that a higher potassium intake is associated with lower BPs, particularly when coupled concurrently with a lower sodium intake giving a lower sodium to potassium ratio. Most hypertension guidelines, while recommending reduction of salt intake to a set target, do not specifically recommend a target for potassium intake nor potassium supplementation. Here we review the role of potassium and salt substitution with potassium in the management of hypertension. Hence, the focus of dietary changes to lower BP and improve BP control should not be on reduction of salt intake alone but more importantly should include an increase in potassium intake.
心血管疾病（CVD）仍然是全球死亡和残疾的主要原因，其中主要促成因素是高血压。尽管在高血压检测方面有了诸多改进，并且技术不断进步，同时有了价格合理、有效且相对无不良反应的抗高血压药物，但我们在预防高血压发病以及将血压（BP）控制在可接受目标方面仍面临困难。高血压控制不佳通常是由于不坚持服药。另一个原因是未能采取饮食和生活方式的改变。减少饮食中的盐摄入量对降低血压很重要，但钾摄入量的作用也很重要。在全球范围内，钠的摄入量是每天推荐的2克（相当于5克氯化钠/盐）的两倍，而钾的每日推荐摄入量为3500毫克/天，钠摄入量仅为其一半，钠钾比>1，而理想情况下该比例应<1。许多研究表明，较高的钾摄入量与较低的血压相关，尤其是当同时摄入较低的钠，使钠钾比降低时。大多数高血压指南虽然建议将盐摄入量减少到设定目标，但并未具体推荐钾摄入量目标或钾补充剂。在此，我们综述钾以及用钾替代盐在高血压管理中的作用。因此，降低血压和改善血压控制的饮食改变重点不应仅在于减少盐摄入量，更重要的是应包括增加钾摄入量。
