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Recommendations Summary

HTN: Potassium 2008

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

  • Recommendation(s)


    Dietitians should advise individuals to consume adequate food sources of potassium as part of Medical Nutrition Therapy to reduce blood pressure. Research suggests that potassium intake lower than recommended levels (DRI) is associated with increased blood pressure.

    Rating: Fair

    • Risks/Harms of Implementing This Recommendation

      Potassium from food, supplements or salt substitutes can result in hyperkalemia and possibly sudden death if excess is consumed by individuals with impaired kidney function and/or taking ACE inhibitors, renin inhibitors, angiotensin receptor blockers (ARBs), potassium-sparing diuretics or aldosterone antagonists.

    • Conditions of Application

      No conditions specified.

    • Potential Costs Associated with Application


    • Recommendation Narrative

      • Five studies with potassium intakes below recommended levels report an association with increased blood pressure (Cheung et al, 2000; Geleijnse et al, 2003; Hajjar and Kotchen, 2003; Geleijnse et al, 2004; Zhao et al, 2004).
      • Based on three randomized controlled trials and two meta-analyses, an increase in potassium intake of 200 to 2, 000 mg per day (5 to 50 mmol per day) results in a significant reduction in systolic blood pressure of approximately 2-8 mmHg and in diastolic blood pressure of approximately 2-6 mmHg (Espeland et al, 2002; Geleijnse et al, 2003; Naismith et al, 2003; Geleijnse et al, 2004, Wu et al, 2006).
      • Seven studies report no association between potassium intake and blood pressure; however, five of these studies report a positive association between the sodium-potassium ratio and blood pressure (Silaste et al, 2000; Hu and Tian, 2001; Liu et al, 2001, Schroder et al, 2002; Kwok et al, 2003; Khaw et al, 2004; Lancaster et al, 2004).

    • Recommendation Strength Rationale

      • Conclusion Statement is Grade II

    • Minority Opinions

      Consensus reached.