[Potassium substitution: is replacing sodium with potassium-enriched salts beneficial?]

backgroundHypertension is the leading cause of premature death globally, and acute decompensated heart failure is among the most common causes of hospitalization. Both conditions are adversely affected by high dietary sodium intake. In contrast, potassium has been shown to lower blood pressure. Substituting dietary sodium with potassium may therefore reduce morbidity and mortality associated with hypertension and possibly heart failure.

objectivesThis review summarizes the current evidence on the cardiovascular effects of dietary sodium and potassium-containing salts. CURRENT DATA: Epidemiological studies consistently demonstrate that high sodium intake is associated with elevated blood pressure and increased rates of cardiovascular morbidity and mortality. Meta-analyses indicate that reducing sodium intake lowers blood pressure and reduces cardiovascular events. In a cluster-randomized trial, partial substitution of sodium chloride with potassium-enriched salt reduced cardiovascular morbidity and mortality in patients with hypertension. However, robust data on the effects of sodium restriction or potassium substitution on hard cardiovascular outcomes in patients with heart failure remain limited.

conclusionsHigh sodium intake has detrimental effects on cardiovascular health. Substituting sodium with potassium-containing salts represents a promising strategy to reduce morbidity and mortality associated with hypertension.