Effect of Low Sodium and High Potassium Diet on Lowering Blood Pressure and Cardiovascular Events

Overview

Journal Clin Hypertens

Publisher Biomed Central

Date 2024 Jan 1

PMID 38163867

Authors

Byung Sik Kim

Mi-Yeon Yu

Jinho Shin

Affiliations

Soon will be listed here.

Abstract

Incorporating aggressive lifestyle modifications along with antihypertensive medication therapy is a crucial treatment strategy to enhance the control rate of hypertension. Dietary modification is one of the important lifestyle interventions for hypertension, and it has been proven to have a clear effect. Among food ingredients, sodium and potassium have been found to have the strongest association with blood pressure. The blood pressure-lowering effect of a low sodium diet and a high potassium diet has been well established, especially in hypertensive population. A high intake of potassium, a key component of the Dietary Approaches to Stop Hypertension (DASH) diet, has also shown a favorable impact on the risk of cardiovascular events. Additionally, research conducted with robust measurement methods has shown cardiovascular benefits of low-sodium intake. In this review, we aim to discuss the evidence regarding the relationship between the low sodium and high potassium diet and blood pressure and cardiovascular events.

Citing Articles

Drones and Workers of Honeybee L. Dried Powder: Chemical Composition, Antioxidant, and Anticancer Assessment.

Abedelmaksoud T, El-Masarawy M, Altemimi A, Hesarinejad M, Hussein A, Smuda S Food Sci Nutr. 2024; 12(12):10357-10369.

PMID: 39723047 PMC: 11666825. DOI: 10.1002/fsn3.4581.

Usage of table salt and risk of all-cause and cardiovascular disease mortality among patients with diabetes: a national population-based cohort study.

Wang Y, Chen H Diabetol Metab Syndr. 2024; 16(1):266.

PMID: 39523348 PMC: 11552236. DOI: 10.1186/s13098-024-01511-9.

Does casual urine Na/K ratio predict 24 h urine Na/K ratio in treated hypertensive patients? Comparison between casual urine voided in the morning vs. 24 h urine collected on the previous day.

Arakawa K, Tominaga M, Sakata S, Tsuchihashi T Hypertens Res. 2024; 48(2):772-779.

PMID: 39394517 DOI: 10.1038/s41440-024-01945-8.

Targeted Approaches: Choosing Sodium Reduction Methods Based on Salt Usage Habits.

Hu N, McLean R Nutrients. 2024; 16(17).

PMID: 39275134 PMC: 11397227. DOI: 10.3390/nu16172816.

Chloride/Multiple Anion Exchanger SLC26A Family: Systemic Roles of SLC26A4 in Various Organs.

Lee D, Hong J Int J Mol Sci. 2024; 25(8).

PMID: 38673775 PMC: 11050216. DOI: 10.3390/ijms25084190.

References

Zanetti D, Bergman H, Burgess S, Assimes T, Bhalla V, Ingelsson E . Urinary Albumin, Sodium, and Potassium and Cardiovascular Outcomes in the UK Biobank: Observational and Mendelian Randomization Analyses. Hypertension. 2020; 75(3):714-722. PMC: 8032218. DOI: 10.1161/HYPERTENSIONAHA.119.14028. View

Huang L, Trieu K, Yoshimura S, Neal B, Woodward M, Campbell N . Effect of dose and duration of reduction in dietary sodium on blood pressure levels: systematic review and meta-analysis of randomised trials. BMJ. 2020; 368:m315. PMC: 7190039. DOI: 10.1136/bmj.m315. View

Hoorn E, Gritter M, Cuevas C, Fenton R . Regulation of the Renal NaCl Cotransporter and Its Role in Potassium Homeostasis. Physiol Rev. 2019; 100(1):321-356. DOI: 10.1152/physrev.00044.2018. View

Turck D, Castenmiller J, de Henauw S, Hirsch-Ernst K, Kearney J, Knutsen H . Dietary reference values for sodium. EFSA J. 2020; 17(9):e05778. PMC: 7009309. DOI: 10.2903/j.efsa.2019.5778. View

Wang M, Cuevas C, Su X, Wu P, Gao Z, Lin D . Potassium intake modulates the thiazide-sensitive sodium-chloride cotransporter (NCC) activity via the Kir4.1 potassium channel. Kidney Int. 2018; 93(4):893-902. PMC: 6481177. DOI: 10.1016/j.kint.2017.10.023. View

Singer P, Cohen H, Alderman M . Assessing the associations of sodium intake with long-term all-cause and cardiovascular mortality in a hypertensive cohort. Am J Hypertens. 2014; 28(3):335-42. PMC: 4402347. DOI: 10.1093/ajh/hpu141. View

Wade J, Fang L, Coleman R, Liu J, Grimm P, Wang T . Differential regulation of ROMK (Kir1.1) in distal nephron segments by dietary potassium. Am J Physiol Renal Physiol. 2011; 300(6):F1385-93. PMC: 3119145. DOI: 10.1152/ajprenal.00592.2010. View

Lerchl K, Rakova N, Dahlmann A, Rauh M, Goller U, Basner M . Agreement between 24-hour salt ingestion and sodium excretion in a controlled environment. Hypertension. 2015; 66(4):850-7. PMC: 4567387. DOI: 10.1161/HYPERTENSIONAHA.115.05851. View

Wilde M, Garvin S . A concept analysis of self-monitoring. J Adv Nurs. 2007; 57(3):339-50. DOI: 10.1111/j.1365-2648.2006.04089.x. View

10.

. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. Lancet. 2021; 398(10304):957-980. PMC: 8446938. DOI: 10.1016/S0140-6736(21)01330-1. View

11.

Rieg T, Vallon V, Sausbier M, Sausbier U, Kaissling B, Ruth P . The role of the BK channel in potassium homeostasis and flow-induced renal potassium excretion. Kidney Int. 2007; 72(5):566-73. DOI: 10.1038/sj.ki.5002369. View

12.

Whelton P, He J, Cutler J, Brancati F, Appel L, Follmann D . Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA. 1997; 277(20):1624-32. DOI: 10.1001/jama.1997.03540440058033. View

13.

Yang L, Sandberg M, Can A, Pihakaski-Maunsbach K, McDonough A . Effects of dietary salt on renal Na+ transporter subcellular distribution, abundance, and phosphorylation status. Am J Physiol Renal Physiol. 2008; 295(4):F1003-16. PMC: 2576159. DOI: 10.1152/ajprenal.90235.2008. View

14.

Vegter S, Perna A, Postma M, Navis G, Remuzzi G, Ruggenenti P . Sodium intake, ACE inhibition, and progression to ESRD. J Am Soc Nephrol. 2011; 23(1):165-73. PMC: 3269916. DOI: 10.1681/ASN.2011040430. View

15.

He F, MacGregor G . Salt reduction lowers cardiovascular risk: meta-analysis of outcome trials. Lancet. 2011; 378(9789):380-2. DOI: 10.1016/S0140-6736(11)61174-4. View

16.

Brown I, Dyer A, Chan Q, Cogswell M, Ueshima H, Stamler J . Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations: the INTERSALT study. Am J Epidemiol. 2013; 177(11):1180-92. PMC: 3664342. DOI: 10.1093/aje/kwt066. View

17.

Tanaka T, Okamura T, Miura K, Kadowaki T, Ueshima H, Nakagawa H . A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens. 2002; 16(2):97-103. DOI: 10.1038/sj.jhh.1001307. View

18.

Cook N, Appel L, Whelton P . Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014; 129(9):981-9. PMC: 4181831. DOI: 10.1161/CIRCULATIONAHA.113.006032. View

19.

Bie P . Mechanisms of sodium balance: total body sodium, surrogate variables, and renal sodium excretion. Am J Physiol Regul Integr Comp Physiol. 2018; 315(5):R945-R962. DOI: 10.1152/ajpregu.00363.2017. View

20.

Su X, Zhang C, Wang L, Gu R, Lin D, Wang W . Disruption of KCNJ10 (Kir4.1) stimulates the expression of ENaC in the collecting duct. Am J Physiol Renal Physiol. 2016; 310(10):F985-93. PMC: 5002054. DOI: 10.1152/ajprenal.00584.2015. View