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Role of dietary potassium and salt substitution in the prevention and management of hypertension.

作者信息

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

机构信息

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.

出版信息

Hypertens Res. 2025 Jan;48(1):301-313. doi: 10.1038/s41440-024-01862-w. Epub 2024 Oct 29.


DOI:10.1038/s41440-024-01862-w
PMID:39472546
Abstract

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.

摘要

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[1]
Role of dietary potassium and salt substitution in the prevention and management of hypertension.

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引用本文的文献

[1]
Exploring the causal effects of physical activity, diet, and nutrition on hypertension and hyperlipidemia: a multivariable Mendelian randomization analysis.

BMC Cardiovasc Disord. 2025-3-18

[2]
Effect of population-based sodium reduction interventions on blood pressure: a systematic review and meta-analysis of randomized trials.

Hypertens Res. 2025-3-7

[3]
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Hypertens Res. 2025-1

本文引用的文献

[1]
Salt reduction policy for out of home sectors: a supplementary document for the salt reduction strategy to prevent and control non-communicable diseases (NCDS) in Malaysia 2021-2025.

Health Res Policy Syst. 2024-4-18

[2]
Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults.

J Am Coll Cardiol. 2024-2-20

[3]
Potassium-Enriched Salt Substitutes: A Review of Recommendations in Clinical Management Guidelines.

Hypertension. 2024-3

[4]
Estimation of 24-hour urinary sodium and potassium excretion among Chinese adults: a cross-sectional study from the China National Nutrition Survey.

Am J Clin Nutr. 2024-1

[5]
Association of serum potassium level with dietary potassium intake in Chinese older adults: a multicentre, cross-sectional survey.

BMJ Open. 2023-11-24

[6]
Salt substitution and salt-supply restriction for lowering blood pressure in elderly care facilities: a cluster-randomized trial.

Nat Med. 2023-4

[7]
"Eating Out", spatiality, temporality and sociality. A database for China, Indonesia, Japan, Malaysia, Singapore and France.

Front Nutr. 2023-2-2

[8]
Perceptions, barriers and enablers of salt reduction in Malaysian out-of-home sectors (MySaltOH): from the point of view of policy-makers and food industries.

Health Res Policy Syst. 2023-2-9

[9]
The Proportion of Dietary Salt Replaced With Potassium-Enriched Salt in the SSaSS: Implications for Scale-Up.

Hypertension. 2023-5

[10]
Association between dietary sodium, potassium, and the sodium-to-potassium ratio and mortality: A 10-year analysis.

Front Nutr. 2022-11-11

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