In a perspective paper published in The American Journal of Clinical Nutrition, a team of researchers and health experts calls for a \u2018paradigm shift\u2019 in how public health agencies address hypertension, which affects more than 1.28 billion adults worldwide and remains a leading driver of cardiovascular disease. The authors say high blood pressure can be controlled better with a strategy that combines boosting potassium intake with reducing sodium.<\/p>\n
Potassium-rich foods include fruits, vegetables, legumes and dairy. Image credit: Jasmine Lin.<\/p>\n
The World Health Organization (WHO) currently recommends adults consume less than 2,000 milligrams of sodium per day and more than 3,500 milligrams of potassium.<\/p>\n
Yet global sodium intake averages roughly double that limit, while potassium intake in many countries falls well short of the target.<\/p>\n
Most dietary sodium in wealthy nations comes not from the salt shaker at home but from food purchased outside it, particularly packaged and restaurant fare.<\/p>\n
In their new paper, University of Vermont\u2019s Professor Naomi Fukagawa and her colleagues argue that sodium reduction alone has proven difficult to sustain at a population level, hampered by consumers\u2019 preference for salty flavors and the technical challenges of reformulating food.<\/p>\n
Meanwhile, evidence for potassium\u2019s independent role in controlling blood pressure has strengthened.<\/p>\n
\u201cHypertension affects over 1.28 billion adults worldwide and is a leading risk factor for cardiovascular disease,\u201d the researchers said.<\/p>\n
\u201cExcessive sodium intake and insufficient potassium consumption are major modifiable contributors to elevated blood pressure, leading the WHO to recommend sodium intake below 2,000 mg\/d and potassium intake above 3,500 mg\/d.\u201d<\/p>\n
\u201cImportantly, hypertension is the driver of cardiovascular disease risk and not merely a marker of excess sodium intake.\u201d<\/p>\n
\u201cDespite the current dietary guidelines, average sodium intake remains significantly above recommendations, whereas potassium intake is often far below optimal levels in both developed and developing nations.\u201d<\/p>\n
\u201cHistorically, sodium reduction has been the targeted strategy for public health interventions to reduce population blood pressure.\u201d<\/p>\n
\u201cFood manufacturers have been using potassium chloride and other potassium-containing ingredients as a tool to reduce sodium over the years, but new understanding of potassium\u2019s critical role and efficacy in reducing blood pressure calls for a paradigm shift to consider sodium and potassium together when developing recommendations.\u201d<\/p>\n
The scientists point to a biological mechanism known as the renal potassium switch, which governs how the kidneys balance sodium and potassium during urine formation.<\/p>\n
This system evolved to help the body conserve scarce potassium, but works against modern diets that are high in sodium and low in potassium, inadvertently driving up blood pressure.<\/p>\n