Potassium metabolism and therapy in hypertension

Several studies are available now to highlight the use of K salts in the management of hypertension. Potassium supplements correct diuretic-induced K loss and also lower the blood pressure. However, salt-sensitive hypertension might not respond to K therapy. It acts as a diuretic and reduces plasma volume by inhibiting sodium reabsorption in the renal tubules. It has a vasodilatory effect on the arterioles by directly acting on the smooth muscle cells. Potassium also suppresses plasma renin activity which is not a uniform observation, however; patients who do not respond to K can have a raised plasma renin activity. Potassium might also inhibit neurogenic mechanisms in reducing blood pressure by inhibiting catecholamines. The notion that a low sodium and high K diet can reduce blood pressure without antihypertensive drug therapy is quite interesting because a large number of subjects with subnormal and mild hypertension can benefit from this remedy. However, long term prospective studies would be necessary to generalize the use of K salts in the prevention and treatment of hypertension.