Introduction
Potassium is a mineral that plays numerous important functions in the body.
It is present in high amounts in most fruits, and also found in vegetables,
legumes, and dairy products. While humans evolved on a diet very high in
potassium and low in sodium, the modern diet is high and sodium and low in
potassium. Thus, the human body effectively retains sodium and readily excretes
potassium, and the combination of this with the modern diet can result in
sodium overload and potassium depletion [1]. In turn, this may be an important
contributor to the high incidence of high blood pressure and cardiovascular
disease in modern times. This article will discuss some of the research on
the role dietary potassium plays in the development of high blood pressure
and cardiovascular disease.
Blood pressure
A large amount of research has been done on the relationship between potassium
intake and blood pressure. Research on this relationship has been difficult
for numerous reasons, including interindividual variation, difficulty in
measuring electrolyte intake, the fact that sodium and potassium intake tend
to change simultaneously, and the fact that self-report data is often biased.
However, there is now considerable evidence that both increasing potassium
and decreasing sodium intake is beneficial for blood pressure control, although
the effect of sodium has been more consistently observed [2].
Epidemiological and cross-cultural studies indicate that populations and
individuals consuming greater amounts of potassium haver lower blood pressure
[3-4]. Many large trials have also been conducted, and some, but not all,
indicate that supplementation with potassium reduces blood pressure in those
with both high and normal blood pressure [4-5]. A meta-analysis of 33 trials
found that potassium supplementation caused an average decrease in systolic
and diastolic blood pressure of 3.1 and 2.0 mmHg respectively. Many clinical
trials also suggest that this effect is greater among those with low dietary
intake of potassium [4]. One large-scale trial indicated that increasing
dietary potassium causes a blood pressure reduction similar to that of most
blood pressure medications [1].
There are multiple reasons why potassium decreases blood pressure. First,
potassium facilitates sodium excretion. Potassium may also directly cause
vasodilation. Potassium also reduces cardiac sensitivity to catecholamins
and angiotensin II and suppresses sodium-induced increases in catecholamines
[1, 6]. Increasing potassium intake, even in the presence of high sodium
intake, has an effect similar to that of reducing sodium intake [3]. The
benefits of reducing dietary sodium and increasing potassium may be additive,
as the dietary ratio seems to be more important than the total dietary content
of either [1].
The response to potassium supplementation varies from individual to individual.
One study on eight healthy subjects found that in two of them the sodium/potassium
ratio was correlated with blood pressure whereas no effect was seen in the
other eight [7], while a larger study found that 47% of normotensive adults
were sensitive to dietary sodium and potassium [3]. Factors that play a role
in individual variation include genetics, gender, body size, and age [2].
Stroke
Another related benefit of high amounts of dietary potassium is decreased
stroke risk. Epidemiologically, diets high in potassium are associated with
up to a 40% reduction in the incidence of stroke, but this is when other
dietary factors are not controlled for [1]. However, several studies that
controlled for other dietary factors found that increased amounts of dietary
potassium are associated with a significant reduction in stroke risk, including
a 12-year study on over 800 subjects [8]. This reduction in stroke risk occurs
in those with both high and normal blood pressure, and is greater in men
[9].
Recommendations & precautions
The best way to increase potassium intake is to consume foods that are high
in potassium. A low dose potassium supplement (100-500 mg) is also not a
bad idea, although high amounts of potassium supplements should not be taken
without medical supervision. Blood levels of potassium are tightly regulated,
and highly bioavailable potassium supplements may increase blood levels significantly,
leading to the possibility of acute toxicity. Using a protein powder or MRP
with high potassium content is an easy way to increase the amount of potassium
in the diet. Following are some of the products highest in potassium:
Protein powders/low carb:
MRPs:
Weight gainers:
If you have any questions or comments regarding this article, please email
dvdtlsn@bulknutrition.com.
No part of this article may be reproduced in any form without the permission of David Tolson or Mike McCandless. 
