26/05/2026
Everyone talks about cutting sodium. Almost nobody talks about adding potassium. The evidence says the latter may be just as (if not more) important
A WHO-commissioned meta-analysis pulled together 22 randomized trials and 1,606 participants. The headline number: in adults with high blood pressure, increasing potassium intake dropped systolic blood pressure by an average of 3.5 mmHg. In the subset of studies where intake reached 90 to 120 mmol per day (about 3,500 to 4,700 mg), the drop was 7.2 mmHg.
Important caveat the meta-analysis flagged: this effect was only seen in people with hypertension. In normotensive adults, the BP change was not statistically significant. The same paper also notes there was no clean dose-response relationship established between the two effect sizes. Two data points, not a smooth curve.
The mechanism is straightforward. Potassium does two things at once. It signals the kidney to excrete more sodium in urine by inhibiting a sodium reabsorption channel called NCC in the distal tubule. It also relaxes vascular smooth muscle directly by opening potassium channels in the arterial wall, which hyperpolarizes the muscle cells and reduces vascular tone. Two mechanisms, one ion.
The stroke data is even more compelling. Across 11 cohort studies and 127,038 adults, higher potassium intake tracked with a 24% lower risk of stroke. That is association data, not RCT-grade causation, but it lines up with what the trials show for blood pressure.
Now the intake gap. The 2019 National Academies set adequate intake at 2,600 mg per day for women and 3,400 mg for men. NHANES data puts the US adult average somewhere around 2,300 mg. Most people are below target, and the gap is bigger for women in absolute terms.
Closing it is not complicated. One banana delivers about 420 mg. One baked potato with skin gives you 925 mg. One cup of cooked spinach is 840 mg. One cup of white beans is 1,190 mg. Adding one of those to an average day gets most adults into the target range.
Cutting sodium is fine if you do it. Adding potassium does something on its own.
Aburto et al., BMJ 2013
NIH Office of Dietary Supplements, 2024
USDA FoodData Central