Salt and High Blood Pressure - What’s Better: Sodium or Potassium?

Glenn Gandelman, MD, MPH

In one word, potassium. Nearly 95% of the high blood pressure in the world is known as primary, essential, or idiopathic hypertension. It is called this because no clear underlying cause can be identified. Instead, doctors simply treat the high blood pressure, never actually curing it. The underlying mechanism of such high blood pressure involves sodium chloride, otherwise known as salt.

Groups of people who eat less than 3 grams of sodium chloride per day rarely have high blood pressure. Although most people who have high blood pressure consume 3 to 6 grams of salt per day, the opposite is not necessarily true. In other words, most people who do consume a large amount of sodium do not have high blood pressure. It thus seems that high sodium intake is necessary but not enough to raise one’s pressure. The missing element is potassium. If one has both a high sodium and a low potassium diet, high blood pressure is likely to result.

A Western diet, such as in the United States, is high in sodium and low in potassium. For example, ham has 8 times more sodium than potassium, and canned chicken soup has 34 times more sodium. Diets in other parts of the world, rich in fruits and vegetables, tend to have foods much higher in potassium. An orange contains no sodium and lots of potassium and boiled peas contain nearly 33 times more potassium than sodium. Interestingly, when an individual from a society where foods are rich in potassium moves to a Western society, their blood pressure rises.

Studies show that increasing potassium intake lowers blood pressure, reduces risk of stroke and kidney disease, and prevents the thickening of heart muscle due to high blood pressure. Additionally, in those with high blood pressure, increasing the potassium reduces the need for blood pressure medication and in some cases allows for patients to completely stop their blood pressure pills.

Below are some foods high in potassium:

  • Apricots
  • Bran Wheat
  • Raisins
  • Figs
  • Potatoes
  • Prunes
  • Bananas
  • Cantaloupe
  • Beets
  • Tomatoes

Can a person eat too much potassium? A healthy person can eat as much potassium in the diet as they like. Excessive potassium can, however, present a problem in those with kidney or heart disease. It is important to discuss any major changes in diet with your doctor and possibly seek the opinion of a nutritionist.

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