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Diseases

High blood pressure — is salt to blame, or a lack of potassium?

Sources: 11 · Article: 14 427 characters

There is no single agreed answer: Jerzy Zięba rejects salt as a cause of high blood pressure, while Prof. Klaus F. Kopp points to a bicarbonate deficiency.

  • Prof. Klaus F. Kopp also warns against excessive salt intake in people with high blood pressure.
  • Henryk Różański describes a short-term drop in blood pressure after potassium sulfate, but does not identify a lack of potassium as a cause of high blood pressure.
  • Henryk Różański links low potassium levels with magnesium deficiency and lists high blood pressure among the symptoms of long-term magnesium deficiency.

What the authors write

Jerzy Zięba

Eating salt does not contribute to high blood pressure; in fact, properly used salt is said to lower blood pressure.

„They clearly show that this is a myth. In short, it is not true. It is also interesting that if a person were deprived of all salt, they would sooner or later die. But most interesting of all is that the proper use of the right kind of salt lowers blood pressure.”Wskazują one jednoznacznie, że jest to mit. Krótko mówiąc nie jest to prawda. Ciekawe jest też to, że jeśli człowiekowi odebrać całkowicie sól, wcześniej czy później umrze. Jednak najciekawsze jest to, że właściwe zastosowanie właściwej soli obniża ciśnienie tętnicze krwi.
O soli
Jerzy Zięba

Low-salt diets are harmful to people.

„This is exactly why all kinds of low-salt diets are harmful to people. The “salt phobia” spread by the media has caused many people to boast that they hardly use any salt at all. They might just as well say: “Why should I eat well when I can eat badly?””Z tego powodu właśnie wszelkiego rodzaju diety nisko solne są dla człowieka szkodliwe. Rozpowszechniana przez media „solofobia” spowodowała, że wiele osób chwali się tym, że soli właściwie wcale nie używa. Osoby te równie dobrze mogłyby powiedzieć: „po co mam się odżywiać dobrze, kiedy mogę odżywiać się źle”.
O soli
Henryk Różański

In the author's tests, potassium sulfate caused a drop in blood pressure that he described as noticeable but short-lived.

„I also felt warmth in my cheeks and, at the same time, a drop in blood pressure. The blood-pressure-lowering effect of potassium sulfate is relatively noticeable, but short-lived. The first bowel movement occurs 2-3 hours after taking it, sometimes as soon as 1 hour later. The number of bowel movements ranges from 3 to 5, sometimes even up to 8, depending on how much food has recently been eaten, how full the intestines are, and how much fluid is consumed.”Sam również odczułem uczucie ciepła na policzkach i zarazem spadek ciśnienia krwi. Wpływ hipotensyjny siarczanu potasu jest stosunkowo wyraźny, ale krótkotrwały. Po 2-3 godzinach, czasem już po 1 godzinie od spożycia następuje pierwsze wypróżnienie. Ilość wypróżnień waha się od 3 do 5, czasem nawet do 8, zależnie od ilości aktualnie spożywanego pokarmu, wypełnienia jelit i ilości wypijanych płynów.
Siarczan potasu – Kalium sulfuricum jako lek w dawnej medycynie.
Henryk Różański

Magnesium deficiency may be accompanied by low potassium levels, and high blood pressure is listed among the symptoms of long-term magnesium deficiency.

„Magnesium deficiency is often accompanied by hypokalemia (a drop in potassium) that does not resolve when potassium is given, and hypocalcemia (a drop in calcium) that does not respond to calcium treatment. Symptoms of long-term magnesium deficiency include progressive atherosclerosis, muscle weakness, painful cramps, convulsions, trembling limbs, eyelid twitching, shortness of breath, frequent gasping, apathy, depression, and sometimes hallucinations; cardiovascular disorders (extra heartbeats, ventricular flutter and fibrillation, high blood pressure, coronary insufficiency); spasms of the esophageal sphincter, paralytic bowel obstruction, positive Chvostek’s and Trousseau’s signs (spasms of the facial muscles; contractures, clenched hands), tongue tremor, paresthesia (numbness and tingling, or sensations of heat or cold in different parts of the body), and reduced resistance to infections.”Przy niedoborze magnezu występuje często hipokaliemia (spadek potasu), który nie ustępuje przy podawaniu potasu; hipokalcemia (spadek wapnia) oporna na podawanie wapnia. Objawami długotrwałego niedoboru magnezu są: postępująca miażdżyca, osłabienie mięśni, bolesne przykurcze, drgawki, drżenie kończyn, drżenie powiek, zadyszka, częste utraty tchu, apatia, depresja, niekiedy omamy, zaburzenia sercowo-naczyniowe (skurcze dodatkowe, trzepotanie i migotanie komór, nadciśnienie tętnicze, niewydolność naczyń wieńcowych); skurcze zwieracza przełyku, niedrożność porażenna jelit, dodatni objaw Chvostek’a i Trousseau (skurcze mięśni mimicznych twarzy; przykurcze, zaciśnięcie dłoni), drżenie języka, parestezje (uczucie drętwienia i mrowienia, odczuwanie gorąca lub zimna w różnych okolicach ciała), spadek odporności na infekcje.
Zaburzenia gospodarki magnezowej.
Prof. Klaus F. Kopp

Prof. Klaus F. Kopp attributes high blood pressure to a bicarbonate deficiency and claims that replenishing bicarbonate can treat it effectively.

„However, the generalized vasoconstriction underlying hypertension is a direct consequence of NaHCO3 deficiency and is caused by the release of vasoconstrictive hormones (the renin-aldosterone-angiotensin cascade). Accordingly, “anti-” drugs are used as treatment. The bicarbonate deficiency itself is never corrected. Sodium bicarbonate would be the most physiologically effective vasodilating substance. In fact, consistent bicarbonate replacement, with the bicarbonate stores kept saturated, can effectively treat hypertension by bringing about a state of “alkalotic volume contraction.””Die der Hypertonie zugrunde liegende generalisierte Vasokonstriktion ist jedoch die direkte Folge des NaHCO3-Mangels und wird durch eine Ausschüttung vasokonstriktiver Hormone (Renin-Aldosteron-Angiotension-Kaskade) bewirkt. Therapeutisch werden daher entsprechende „Anti“-Medikamente eingesetzt. Nur der Bikarbonat-Mangel wird nirgendwo beseitigt. Natrium-Bikarbonat wäre dabei die physiologisch am besten wirkende vasodilatatorische Substanz. Tatsächlich gelingt es durch konsequente Bikarbonat-Substitution mit dauerhafter Sättigung der Bikarbonat-Speicher eine Hypertonie wirksam zu therapieren, der Zustand der „alcalotic volume-contractions“ wird hierdurch herbeigeführt.
Das Bikarbonat-Mangel-Syndrom (BDS): Professor Dr. med. Klaus F. Kopp
Prof. Klaus F. Kopp

Prof. Klaus F. Kopp notes that salt can be harmful in certain situations, while sodium bicarbonate at ordinary concentrations may be beneficial.

„NaCl = Salt may indeed be harmful or “bad” in certain situations. Sodium bicarbonate, NaHCO3, is the natural physiological buffer in the mammalian organism, and if it is supplemented at normal concentrations, it may be considered “good”. However, the excessive intake of 100 grams of sodium bicarbonate is certainly not advisable and would require medical treatment.”NaCl = Salt may indeed be harmful or “bad” in certain situations. Sodium Bicarbonate, NaHCO3, is the natural physiological buffer in the mammalian organism and and if it is substituted at normal concentrations it may be considered as “good”. However, the excessive intake of 100 Gram of Sodium Bicarbonate is certainly not advisable and would require medical treatment.
The Bicarbonate-Deficiency-Syndrome (BDS): Professor Dr. med. Klaus F. Kopp
Prof. Klaus F. Kopp

Prof. Klaus F. Kopp writes that people with high blood pressure should not eat too much salt.

„This unfortunately makes confusion with other sodium salts, especially sodium bicarbonate, inevitable. But since nobody should eat too much salt—least of all people with heart or kidney disease, or high blood pressure, and pregnant women—in other words, nobody at all, desperate efforts are made to keep the total sodium content of mineral waters, various foods, or diet products as low as possible, and to remove or reduce it at great expense, so that no harm is done.”Dadurch ist die Verwechslung mit anderen Natrium-Salzen leider vor allem mit Natrium-Bikarbonat vorprogrammiert Da aber niemand zu viel Salz essen soll, schon gar nicht Herz-, Nieren- oder Hochdruck-Kranke, auch nicht Schwangere, d.h. gar niemand, - wird verzweifelt versucht, den gesamten Natrium-Gehalt von Mineralwässern oder verschiedenen Nahrungsmitteln oder Diätetika, so niedrig wie möglich zu halten und kostenaufwendig zu entfernen oder zu reduzieren, damit ja nur kein Schaden entsteht.
Das Bikarbonat-Mangel-Syndrom (BDS): Professor Dr. med. Klaus F. Kopp

Research from PubMed · Europe PMC

We selected 5 studies with the best, positive results. This is a selection, not a full review of all research.

Total number of studies on this topic in PubMed: 7 827.

A review found that sodium restriction is associated with lower blood pressure, while high salt intake is associated with a greater risk of high blood pressure.

Aim of the study: Excessive salt intake is a known risk factor for cardiovascular disease (CVD), but the health impacts of both high and low sodium intake remain debated. This study synthesizes meta-analytic evidence on dietary salt intake and cardiovascular outcomes, including subgroup and dose-response analyses.

Results: Twenty-one meta-analyses comprising 91 outcomes were included. Low sodium intake was associated with reduced risks of CVD mortality (RR = 0.83, 95% CI: 0.73-0.95), stroke mortality (RR = 0.74, 95% CI: 0.57-0.95), and all-cause mortality (RR = 0.88, 95% CI: 0.82-0.93), as well as lower systolic blood pressure (MD = -3.39 mmHg) and diastolic blood pressure (MD = -1.54 mmHg), improved vascular elasticity, and increased heart rate. Urinary sodium excretion and the Na/K ratio decreased, while urinary potassium and calcium, and serum potassium increased. No adverse effects on lipid profiles were observed. High salt intake was associated with increased risks of CVD (RR = 1.13, 95% CI: 1.06-1.20), hypertension (OR = 1.33, 95% CI: 1.24-1.42), stroke (OR = 1.34, 95% CI: 1.19-1.51), and stroke mortality (OR = 1.40, 95% CI: 1.21-1.63). Each 1 g/day increase in sodium raised systolic blood pressure by 0.60 mmHg and CVD and stroke risks by 4% and 6%, respectively.

Dietary salt intake and cardiovascular outcomes: an umbrella review of meta-analyses and dose-response evidence. · Ann Med 2025
Money for the studyuniversity or foundation · National Natural Science Foundation of China
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studyreview of many studies

“Not stated” does not mean nobody paid — the database does not always record it.

A meta-analysis found that potassium supplementation lowers blood pressure, especially in people with hypertension and those with higher sodium intake, although the relationship was not linear.

Aim of the study: Background: Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship are uncertain.

Results: The BP-lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. An increase in BP with high potassium excretion was noted in participants with hypertension treated with antihypertensive drugs, but not in their untreated counterparts. Conclusions: We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates of the BP effects of high potassium intakes should be interpreted with caution because few trials were available. Our findings indicate that adequate potassium intake is desirable for achieving a lower BP level, but suggest that excessive potassium supplementation should be avoided, particularly in specific subgroups.

Potassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials. · J Am Heart Assoc 2020
Money for the studygovernment, public institutions · European Food Safety Authority (EFSA)
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?NO
Type of studycombined analysis of many studies (meta-analysis)

“Not stated” does not mean nobody paid — the database does not always record it.

A review found that the sodium-to-potassium ratio was more strongly associated with blood pressure than sodium or potassium alone in adults with hypertension.

Aim of the study: The potential cost-effectiveness and feasibility of dietary interventions aimed at reducing hypertension risk are of considerable interest and importance in public health. In particular, the effectiveness of restricted sodium or increased potassium intake in reducing hypertension risk has been demonstrated in clinical and observational research.

Results: The main findings show that, among the randomized controlled trials reviewed, the sodium-to-potassium ratio appears to be more strongly associated with blood pressure outcomes than either sodium or potassium alone in adults with hypertension. Recent data from the observational studies reviewed provide further support for the sodium-to-potassium ratio as a better measure than sodium or potassium alone when assessing blood pressure outcomes and new cases of hypertension. It remains unclear whether this is true in people with normal blood pressure and in children, or for related outcomes including the renin-angiotensin system, arterial stiffness, the augmentation index, and endothelial dysfunction. Further research in these groups is warranted.

Sodium-to-potassium ratio and blood pressure, hypertension, and related factors. · Adv Nutr 2014
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyreview of many studies

“Not stated” does not mean nobody paid — the database does not always record it.

A meta-analysis found that the DASH diet lowers blood pressure, and evidence also points to benefits from salt with less sodium and more potassium.

Aim of the study: Background: Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta-analyses. It is still unclear which intervention would be most effective.

Results: For patients with hypertension, moderate- to high-quality evidence suggested that the listed interventions (except comprehensive lifestyle modification) were associated with greater reductions in systolic and diastolic BP than usual care; salt restriction was also effective in lowering both systolic and diastolic BP. Among overweight and obese participants, a low-calorie diet and a low-calorie diet plus exercise could lower BP more than exercise alone. Conclusions: DASH may be the most effective intervention for lowering BP in adults with prehypertension through to established hypertension. Aerobic exercise, isometric training, low-sodium, high-potassium salt, comprehensive lifestyle modification, salt restriction, breathing control, meditation, and a low-calorie diet also have clear effects on reducing BP.

Nonpharmacologic Interventions for Reducing Blood Pressure in Adults With Prehypertension to Established Hypertension. · J Am Heart Assoc 2020
Money for the studyuniversity or foundation · Chinese Academy of Engineering
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?NO
Type of studycombined analysis of many studies (meta-analysis)
Participants14 923

“Not stated” does not mean nobody paid — the database does not always record it.

A review found that increasing potassium may lower blood pressure, and potassium-enriched salt may also reduce the risk of stroke and cardiovascular death.

Aim of the study: Hypertension is the single most important modifiable risk factor for cardiovascular morbidity and mortality worldwide. Nonpharmacologic interventions, particularly dietary changes, have been shown to lower blood pressure (BP) and reduce hypertension-related cardiovascular events.

Results: Meanwhile, increasing dietary potassium intake has remained on the sidelines, despite similar BP-lowering effects. New research reveals a potential mechanism of action, explaining its effect on sodium excretion through the potassium switch effect. Additionally, potassium-substituted salt has been shown not only to reduce BP, but also to reduce the risk of stroke and cardiovascular mortality. Based on these data, we argue that the focus on dietary modification should shift from sodium alone to both sodium and potassium, with an emphasis on strategies that can be easily implemented in clinical practice.

Potassium and Hypertension: A State-of-the-Art Review. · Am J Hypertens 2024
Money for the studyuniversity or foundation · Lotte & John Hecht Memorial Foundation, University of Ottawa
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studydiscussion of other studies

“Not stated” does not mean nobody paid — the database does not always record it.

Perspectives and opinion materials

The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.

Orthomolecular Medicine News Service Opinion material
„Personally speaking, when I or my children get a significant amount of sodium as sodium ascorbate, we make a point of eating plenty of fruit and vegetables and drinking lots of fresh, raw, homemade vegetable juice (for potassium). We also make sure to get plenty of magnesium through oral supplements and Epsom salt baths.”Personally speaking, when I or my children are getting a significant amount of sodium as sodium ascorbate we make a point to eat lots of fruits and veggies and drink lots of fresh raw homemade veggie juice (for potassium). We also make a point to get plenty of magnesium via oral supplements and Epsom salt baths.
Vitamin C Questions: Answered

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