How Potassium Counters Sodium: Sex-Specific Mechanisms and Clinical Implications for Blood Pressure Control
How Potassium Counters Sodium: Sex-Specific Mechanisms and Clinical Implications for Blood Pressure Control
Source: ISH – December 2025
Key notes:
• Salt sensitivity varies: Blood pressure responses to sodium differ by age, ethnicity, kidney function, obesity, and other factors.
• Only ~50% of hypertensive patients are salt-sensitive, yet reducing excessive sodium intake is recommended for most.
• Potassium counteracts sodium: Increased potassium intake can blunt or even reverse sodium-induced BP elevation, even with high sodium intake.
• Sex-specific mechanisms:
• Men: BP response driven mainly by proximal renal sodium transport.
• Women: Distal sodium transport predominates, resulting in a more attenuated BP rise with sodium load.
• Clinical implications:
• Increasing dietary potassium (fruits, vegetables, potassium-enriched salt) is a powerful, physiologically grounded BP-lowering strategy.
• Potassium can neutralize sodium’s hypertensive effects, supporting global dietary recommendations.
• Sex differences may inform future guideline development and interpretation of clinical trials.
Bottom line:
• Raising potassium intake is a central dietary tool for BP control and helps explain why men and women respond differently to sodium.