Increasing dietary potassium is safe for hypertensive patients treated with ACE inhibitors or ARBs

This study examined the safety of increasing potassium in the diets of patients with hypertension receiving treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). The authors concluded that increasing dietary potassium in these patients had no negative effect on the level of potassium in their blood.

Patients with hypertension need to lower their blood pressure to avoid complications such as heart attacks, strokes and heart failure. ACE inhibitors (such as Lotensin or Captopril) and ARBs (such as Diovan or Atacand) are two types of treatment that can reduce blood pressure. They work by relaxing the blood vessels which reduces the volume of fluid in the blood system. However, ACE inhibitors and ARBs have been linked to increased levels of potassium in the blood. This condition is known as hyperkalemia.

Lifestyle changes, such as diet and exercise, are often recommended for hypertensive patients. Increasing dietary potassium by eating more fruits and vegetables has shown to be an effective way of lowering blood pressure. It is unclear if increasing dietary potassium during treatment with ARBs or ACE inhibitors would increase the risk of developing hyperkalemia. 

20 hypertensive patients receiving treatment with either an ACE inhibitor or an ARB were included in this study. Patients with kidney problems were excluded as this may contribute to the risk of developing hyperkalemia.

10 patients continued with their usual diet and 10 patients were on a high-potassium diet for a week period. Fruit and vegetables were used to increase dietary potassium. Potassium levels in the blood were measured throughout the study.

The group on a high-potassium diet had significantly higher levels of potassium in their urine at the end of the study. No significant increase in blood potassium levels were seen in either group. There were no significant changes to blood pressure with a high-potassium diet.

This study concluded that increasing dietary potassium in hypertensive patients with normal kidney function receiving an ACE inhibitor or an ARB did not increase the risk of hyperkalemia. However, increased potassium intake did not lead to any significant decrease in blood pressure. 

The patient numbers for this study were small and study duration was very short. 

Consult with your physician for advice on changing your diet for management of hypertension.