Potassium
Potassium is an essential mineral; human studies show partly clear, partly mixed effects, especially on blood pressure and potassium balance.
We evaluated 165 human studies on Potassium, including 126 randomised controlled trials and 16 meta-analyses or systematic reviews; the controlled studies include 120,229 participants in total. As of 4 October 2026.
1. What Is Potassium? Occurrence, Origin and Forms
Potassium is an essential mineral and electrolyte. It occurs naturally in many foods, especially fruits, vegetables, legumes, and potatoes. In studies, it is investigated as a dietary component or in the form of salts, for example in relation to blood pressure and cardiovascular function.
Potassium is present in almost all plant and animal cells. In research, it is considered both as part of the usual diet and as an isolated intake in the form of salts.
Potassium salts are obtained from mineral deposits such as sylvite or from salt lakes; various potassium salts are produced for dietary supplements. Studies mainly examine potassium chloride, potassium citrate, potassium bicarbonate, and potassium gluconate, as well as potassium from food.
Forms and Preparations Studied
- Potassium chloride
- Potassium citrate
- Potassium bicarbonate
- Potassium gluconate
- Potassium aspartate
- Dietary potassium
Not covered on this page:
- Sodium and other electrolytes
- Potassium permanganate
- Potassium-sparing diuretics
2. What Does Potassium Do? Results by Area
| Area | Result in controlled studies | Strength of evidence | Studies | Participants |
|---|---|---|---|---|
| Blood pressure | mostly improved | high | 9 meta-analyses · 40 controlled · 11 other | 26,131 |
| Cardiovascular | mixed | moderate | 1 meta-analyses · 18 controlled · 7 other | 20,157 |
| Kidney | mixed | moderate | 0 meta-analyses · 12 controlled · 8 other | 1,062 |
| Diabetes | mostly no difference | low | 0 meta-analyses · 5 controlled · 2 other | 675 |
| Muscle | mostly no difference | low | 0 meta-analyses · 4 controlled · 1 other | 310 |
| Bone | mostly no difference | low | 0 meta-analyses · 2 controlled · 1 other | 21,031 |
| Stroke | mostly improved | low | 0 meta-analyses · 1 controlled · 3 other | 15,249 |
| Other investigations | mixed | moderate | 1 meta-analyses · 61 controlled · 13 other | 63,907 |
How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.
3. What the Studies Show in Detail
Potassium and Blood Pressure: Human Studies
Several meta-analyses of controlled trials showed that increased potassium intake lowers systolic and diastolic blood pressure, markedly in hypertension, more weakly in normotensive individuals 3478911. With potassium chloride, office, home and long-term blood pressure fell in hypertension 77, with another potassium supplement long-term blood pressure fell 92; potassium-enriched salt substitutes lowered blood pressure in hypertension 5. No confirmed blood pressure difference was found by controlled trials with a potassium-rich diet 101 and a plant-based nutrition program 89 in kidney disease as well as with a single potassium-rich meal 99. A potassium supplement also did not change blood pressure in healthy participants 105. A dose-response meta-analysis found a U-shaped course: with very high additional intake the reduction diminished, with medically treated hypertension blood pressure rose 16. The evidence is strong, and most studies show a reduction, especially with supplements and salt substitutes; the data on potassium from food are inconsistent. The forms studied include potassium chloride, potassium citrate, potassium bicarbonate, potassium gluconate, potassium aspartate and potassium from food, partly as combination preparations with sodium chloride or magnesium. It remains open which salt form and dose are most effective and how the effects differ in various pre-existing conditions.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 1 Huang et al. 2021 | meta-analysis · 5,708 participants | Dietary potassium intake (24-h urine); Median 67.7 mmol/day (IQR 54.6-76.4); vs. 50 mmol sodium reduction at different potassium intake levels | Systolic blood pressure with 50 mmol sodium reduction: no difference (p > 0.05); Diastolic blood pressure with 50 mmol sodium reduction: no difference (p > 0.05) |
| 3 Whelton et al. 1999 | meta-analysis · 2,609 participants | Oral potassium supplementation; vs. Placebo/control without potassium | Systolic blood pressure: improved (-4.44 (range, -2.53 to -6.36) mm Hg); Diastolic blood pressure: improved (-2.45 (range, -0.74 to -4.16) mm Hg) |
| 4 Whelton et al. 1997 | meta-analysis · 2,609 participants | Oral potassium supplementation as sole difference from control; vs. Control group without potassium supplementation | Systolic blood pressure: improved (-3.11 mm Hg (-1.91 to -4.31 mm Hg)); Diastolic blood pressure: improved (-1.97 mm Hg (-0.52 to -3.42 mm Hg)) |
| 5 Kelly et al. 2026 | meta-analysis · 1,430 participants | Potassium-enriched salt substitute (potassium chloride replacing sodium chloride); vs. Regular salt (sodium chloride) | Systolic blood pressure: improved (MD, -5.75 mmHg; 95% CI, -6.98 to -2.39 mmHg; I2 = 37%; p < 0.01); Diastolic blood pressure: improved (MD, -1.62 mmHg; 95% CI, -2.34 to -0.91 mmHg; I2 = 0%; p < 0.001) |
| 7 Poorolajal et al. 2017 | meta-analysis · 1,213 participants | Oral potassium supplementation (salt form not specified); at least 4 weeks; vs. Placebo | Systolic blood pressure (final follow-up): improved (MD -4.25 mmHg; 95% CI: -5.96 to -2.53); Diastolic blood pressure (final follow-up): improved (MD -2.53 mmHg; 95% CI: -4.05 to -1.02); Systolic blood pressure (change from baseline): improved (MD -8.89 mmHg; 95% CI: -13.67 to -4.11) |
| 8 Binia et al. 2015 | meta-analysis · 917 participants | Potassium supplementation (salt form not specified); intake corresponding to urinary excretion 60 to 100 mmol/day; vs. control without potassium supplementation | systolic blood pressure, all patients: improved (4.7 mmHg [95% CI 2.4-7.0]); diastolic blood pressure, all patients: improved (3.5 mmHg (95% CI 1.3-5.7)); systolic blood pressure, hypertensive patients: improved (6.8 mmHg (95% CI 4.3-9.3)) |
| 9 Ravichagua et al. 2025 | meta-analysis · 803 participants | Oral potassium supplements (salt form not reported); Median 4 weeks; vs. Placebo, sodium chloride, or no treatment | Clinic systolic blood pressure: improved (−7.2 mmHg (95% CI −11.1 to −3.4)); Clinic diastolic blood pressure: improved (−4.0 mmHg (−6.2 to −1.7)); 24-h ambulatory systolic blood pressure: no difference (−2.4 mmHg (−5.2 to 0.4)) |
| 11 Granal et al. 2025 | meta-analysis | Potassium supplementation, form not specified; 50 mmol/day increase in 24-h urinary potassium excretion; vs. Dose-response comparison of urinary potassium excretion | Systolic blood pressure in subjects without hypertension: improved (0.5 mmHg reduction); Diastolic blood pressure in subjects without hypertension: improved (0.12 mmHg reduction); Systolic blood pressure in subjects with hypertension: improved (5.3 mmHg reduction) |
Further studies in this area: 13 14 15 16 20 22 28 31 38 40 41 43 56 57 65 67 70 71 73 74 75 76 77 78 83 84 87 89 92 93 96 97 99 101 105 106 107 114 116 117 118 119 121 122 126 129 133 135 136 138 141 143
Potassium and Cardiovascular: Human Studies
In stroke survivors, a salt substitute of potassium chloride and sodium chloride lowered mortality in a randomized controlled trial 20. In ICD carriers, potassium-increasing treatment in addition to standard care reduced atrial fibrillation-related events 26. A potassium-rich meal mitigated the drop in flow-mediated dilation after the meal in healthy individuals 99; potassium-increasing treatment slightly improved two diastolic values in ICD carriers 35. Randomized controlled trials found no difference in atrial fibrillation after heart surgery when potassium was supplemented less often 25, and in cardiac rhythm events with a potassium binder during dialysis 24. The evidence is moderate; it remains open which potassium form and dose benefits which patient groups.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 6 Bensaaud et al. 2025 | systematic review · 1,397 participants | DASH diet as a dietary component with increased potassium; Intervention 16 weeks to 12 months, follow-up 16 weeks to 18 months; vs. No intervention/usual care, minimal intervention, or other diets | Myocardial infarction: no difference (no myocardial infarctions in either group) |
| 10 Ono et al. 2026 | meta-analysis | Serum potassium levels (no preparation administered); median 24.2 months (HFrEF) and 36.8 months (HFpEF); vs. potassium <3.5 vs. 4.0-4.5 mmol/L; range 4.2-5.0 mmol/L most favorable | all-cause mortality at potassium <3.5 mmol/L (HFrEF): worsened (adjusted hazard ratio 1.49; 95% confidence interval, 1.27-1.76); cardiovascular, sudden, and pump failure death (HFrEF): worsened; lowest risk for all outcomes at potassium 4.2-5.0 mmol/L: improved (4.2-5.0 mmol/L) |
| 12 Zwager et al. 2025 | meta-analysis | Estimated dietary Na+/K+-ratio (diet); Na+/K+-ratio 2.0 ± 0.6 mmol/mmol; vs. Higher vs. lower Na+/K+-ratio | Cardiovascular events and mortality: worsened (hazard ratio 1.10 [95% confidence interval: 1.06-1.16]) |
| 15 Brand et al. 2022 | systematic review | Potassium-containing low-sodium salt substitutes (LSSS) replacing regular salt; vs. Regular salt or no active intervention | Cardiovascular events and cardiovascular mortality: unclear |
| 20 Ding et al. 2025 | randomised controlled · 15,249 participants | Salt substitute with 75% sodium chloride and 25% potassium chloride vs regular salt; median 61.2 months; vs. regular salt | death rates: improved (RR, 0.88; 95% CI, 0.82-0.96; P = .003); stroke-related deaths: improved (relative reduction 21%; P = .01) |
| 25 O'Brien et al. 2024 | randomised controlled · 1,690 participants | Potassium supplementation (potassium chloride) triggered by serum potassium threshold; Supplement only if serum potassium <4.5 mEq/L (tight) vs <3.6 mEq/L (relaxed); First 120 hours after CABG or until discharge; vs. Tight vs relaxed potassium control | New-onset atrial fibrillation after cardiac surgery: no difference (risk difference of 1.7% (95% CI, -2.6% to 5.9%)); At least 1 AFACS episode by any means: no difference; Non-AFACS dysrhythmias: no difference |
| 26 Zheng et al. 2026 | randomised controlled · 1,200 participants | Potassium-increasing treatment (form not specified) plus standard care; Uptitration to high-normal plasma potassium (increase 0.3 mmol/L); median follow-up 3.3 person-years; vs. standard care alone (control group) | Composite endpoint of atrial fibrillation-related hospitalizations, cardioversion/ablation, inappropriate shock therapy and amiodarone loading: improved (subdistribution hazard ratio, .65; 95% confidence interval, .45-.93, P = .02) |
| 27 Jøns et al. 2025 | randomised controlled · 1,200 participants | Potassium supplementation, mineralocorticoid receptor antagonist, or both plus dietary guidance; Target plasma potassium 4.5–5.0 mmol/l; Median follow-up 39.6 months; vs. Standard care alone | Primary composite end point (sustained VT, ICD therapy, hospitalization, death): improved (hazard ratio, 0.76; 95% confidence interval, 0.61 to 0.95; P = 0.01) |
Further studies in this area: 35 48 65 67 81 89 92 96 99 103 105 106 112 117 124 128 136 139
Potassium and Kidney: Human Studies
In hemodialysis with hyperkalemia, potassium binders reduced hyperkalemia events in a meta-analysis; sodium zirconium cyclosilicate and sodium polystyrene sulfonate lowered the potassium level, while with patiromer the reduction was not confirmed 2. A randomized controlled trial found fewer hyperkalemia episodes with patiromer 95. A two-phase potassium profile in the dialysate lowered serum potassium after dialysis more than a fixed one in a randomized controlled trial 72. In a randomized trial, hyperoxaluria decreased from baseline with potassium magnesium citrate, and more so with an Oxalobacter preparation 62. A randomized controlled trial with extended-release potassium citrate increased urinary potassium 82. In healthy individuals, a potassium supplement increased urinary AQP2 excretion and lowered free water clearance in a randomized controlled trial 105. The studies are mostly small and short; several tested mixtures, such as low-sodium, high-potassium seasonings and salts 3843, and apply only to that preparation.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 20 Ding et al. 2025 | randomised controlled · 15,249 participants | Salt substitute with 75% sodium chloride and 25% potassium chloride vs regular salt; median 61.2 months; vs. regular salt | hyperkalemia (RR, 1.01; 95% CI, 0.74-1.38; P = .96) |
| 32 Khalid et al. 2026 | randomised controlled · 290 participants | Tablets: T1 supplement, T2 placebo, T3 magnesium, T4 magnesium plus potassium; 60 days follow-up; vs. placebo (T2) and magnesium (T3) vs. potassium (T4) | serum urea: improved (p = 0.000); serum creatinine: improved (p = 0.000) |
| 36 Reddy et al. 2014 | randomised controlled · 247 participants | Urikind-KM6: 1,100 mg potassium citrate, 375 mg magnesium citrate, 20 mg pyridoxine hydrochloride per 5 mL; every 8 hours; 3 years; vs. Control group 1 (discontinued due to intolerance), control group 2 (no prophylaxis) | 24-hour urinary citrate excretion: improved (221.79±13.39 mg/dL to 604.04±5.00 mg/dL); urinary pH: improved (5.62±0.2 to 6.87±0.01); stone recurrence rate per patient per year: improved (3.23±1.04 to 0.35±0.47) |
| 37 Khalid et al. 2023 | randomised controlled · 200 participants | Magnesium and potassium supplements (Mg+ and K+), salt form not stated; vs. four groups by supplement, single-blind randomized | kidney markers dependent on cholesterol: no difference |
| 53 Fomkin et al. 2025 | randomised controlled · 100 participants | Dietary supplement Astracit-Asfarma (potassium citrate + magnesium citrate); 60 days; vs. Standard therapy alone (group 3A/3B) | Total volume of residual fragments: improved (decreased by ~30% from the initial postoperative level and more than twice compared to the control group); Density of fragments: improved (decreased by 10-12%); Stone-free rate ≤2 mm: improved (60% in group 1,72% in group 2, and 52% in the control group) |
| 74 Mu et al. 2024 | randomised controlled · 59 participants | CM-DASH diet with 52% low-sodium salt; 8 weeks; vs. CM-DASH diet with regular salt (control group) | Urinary albumin creatinine ratio: improved; Serum creatinine: improved |
| 82 Li et al. 2025 | randomised controlled · 46 participants | Extended-release potassium citrate vs. low-PRAL diet; 4 weeks; vs. Control group | Urine pH: no difference; Urine calcium: no difference; Urine oxalate: no difference |
| 89 Liebman et al. 2025 | randomised controlled · 40 participants | 15-day whole-food plant-based diet (WFPBD) education program; 15 days; vs. Control group without the education program | Serum potassium (p = 0.52); Albumin: no difference; Phosphorus: no difference |
Further studies in this area: 97 101 104 105 107 109 113 115 130 136 140 142
Potassium and Diabetes: Human Studies
For diabetes, five controlled studies are available, but they do not give a uniform picture. In a randomized controlled trial with a mixture of olive leaf extract and potassium, fasting insulin and HOMA index decreased in mildly elevated blood pressure; fasting glucose and HbA1c remained unchanged 65. In a randomized controlled trial with an adapted DASH diet, which among other things contained more potassium, calcium, magnesium and fiber, glycated hemoglobin decreased similarly in both groups in pregnant women with diabetes 67. A randomized controlled trial with magnesium and potassium supplements found no difference in quality of life and cholesterol 37. The evidence is low, because the studies examined different forms, mixtures and populations and no meta-analysis is available. It remains open whether potassium in a specific form or preparation has a benefit in diabetes.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 29 Khalid et al. 2026 | randomised controlled · 320 participants | Potassium alone (T3) and magnesium+potassium (T4); vs. Placebo (T1) and magnesium alone (T2) | HOMA-IR (magnesium+potassium): improved (3.01 ± 0. 54, and post-treatment mean was 2.54 ± 0.29, showing a significant reduction (p = 0.001)); HOMA-IR among treatment groups: improved (p = 0.001); Fasting blood sugar: improved (p = 0.001) |
| 37 Khalid et al. 2023 | randomised controlled · 200 participants | Magnesium and potassium supplements (Mg+ and K+), salt form not stated; vs. four groups by supplement, single-blind randomized | effect of Mg/K therapy on quality of life and cholesterol: no difference |
| 65 Fladerer-Grollitsch et al. 2026 | randomised controlled · 70 participants | Olive leaf extract-potassium supplement vs. placebo; 1000 mg OLE, ≥160 mg oleuropein, 300 mg potassium/day; 12 weeks; vs. placebo, double-blind randomized | Fasting glucose: no difference (unchanged); HbA1c: no difference (unchanged); Fasting insulin and HOMA index: improved (declined in the verum group) |
| 67 Belfort et al. 2023 | randomised controlled · 68 participants | Adapted DASH diet with higher potassium, calcium, magnesium and fibre content; until delivery (18 weeks); vs. Standard diet with 45-65 % carbohydrates, 15-20 % protein, 25-30 % lipids | Glycated haemoglobin: no difference (SDG: -0⋅61 [CI -0⋅26, -0⋅96], P = 0⋅00 v. DDG: -1⋅1 [CI -0⋅57, -1⋅62], P = 0⋅00) |
| 108 Juett et al. 2026 | randomised controlled · 17 participants | 100% fruit juice (Raw Hydrate®) vs. glucose-based sports drink vs. water; Water volume equal to 150% of body mass loss (~2,300 mL juice); 1 h rehydration, 5 h observation; vs. Sports drink and water | Blood glucose AUC: improved (P < 0.001) |
| 125 Chatterjee et al. 2012 | cohort study · 4,754 participants | Dietary potassium (no supplement); 15 and 20 years follow-up; vs. lowest vs highest potassium quintiles | Incident type 2 diabetes, lowest vs highest urinary potassium quintile: worsened (HR 2.45; 95% CI 1.08, 5.59); Diabetes risk with lower potassium intake (African-Americans): worsened |
| 137 Eser et al. 2025 | cohort study · 113 participants | Potassium chloride (KCl) alone or KCl plus potassium phosphate (KPO4); 13-year treatment period; vs. KCl+KPO4 (n=36) versus KCl alone (n=77) | Severity of acidosis: no difference; Duration of acidosis recovery: no difference; Incidence of hypokalemia: no difference |
Potassium and Muscle: Human Studies
Potassium bicarbonate as a supplement, partly combined with whey protein, showed no difference in muscle performance, physical performance and muscle mass in healthy older adults 46. A randomized controlled trial with glucosamine sulfate potassium salt found no difference in the WOMAC score compared with glucosamine sulfate sodium salt in knee osteoarthritis 58. The evidence is low, the studies are small and examine different forms and populations; it remains open whether other potassium forms or higher intakes have an effect in specific groups.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 46 Ceglia et al. 2026 | randomised controlled · 128 participants | Potassium bicarbonate (KHCO3) supplement, partly combined with whey protein; 81 mmol KHCO3 per day; 24 weeks; vs. Placebo-KHCO3 or placebo-whey protein (2×2 factorial) | Muscle power (double leg press): no difference (-13.6 watts [95% CI: -39.6, 12.4; P = 0.30]); Physical performance: no difference; Muscle mass: no difference |
| 58 Wangroongsub et al. 2010 | randomised controlled · 90 participants | Glucosamine sulfate potassium salt (GS-K) vs. glucosamine sulfate sodium salt (GS-Na); 1500 mg daily; until the sixteenth week of treatment; vs. GS-Na 1500 mg daily | WOMAC score: no difference |
| 61 Polo-Ferrero et al. 2025 | randomised controlled · 80 participants | Dietary potassium (nutrient intake assessed by food frequency questionnaire); 32-week intervention; vs. High-speed resistance training vs. multicomponent training | Correlation between potassium intake and 5STS performance (H-RT group): improved (r<sub>p</sub> = -0.47) |
| 112 Killick et al. 2026 | randomised controlled · 12 participants | Sodium-potassium drink vs. water vs. coconut water; 300 ml before and at 0, 30, 60 min postexercise; 60 min cycling at 1.5 W/kg, measures to 90 min postexercise; vs. Water and coconut water | Handgrip strength, countermovement jump, fatigue: no difference (p ≥ .152) |
| 132 Zhang et al. 2022 | cohort study · 392 participants | dietary potassium (assessed by FFQ); 24 months; vs. higher vs. lower potassium intake | lower limb muscle strength: improved |
Potassium and Bone: Human Studies
For bone, the controlled studies do not show a uniform picture: A randomized controlled trial in prehypertensive adults with potassium chloride capsules found changes in phosphate and calcium metabolism parameters, while parathyroid hormone, vitamin D status and plasma calcium remained unchanged 91. A large randomized controlled trial with a potassium chloride-containing salt substitute mixed with sodium chloride found no difference in the frequency of fractures in adults at high cardiovascular and fracture risk 18. An observational study with potassium from food, recorded together with calcium, magnesium and phosphorus, showed no association with knee joint structures in people with knee osteoarthritis 132. The evidence for bone endpoints is low; potassium chloride as a supplement or in the salt substitute as well as potassium from food were examined. It is open whether potassium without sodium chloride influences bone strength.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 18 Wang et al. 2024 | randomised controlled · 20,995 participants | Salt substitute (potassium chloride-containing) vs. regular salt; 5 years; vs. regular salt (control) | Incidence of all fractures: no difference (RR 0.96; 95% CI 0.81 to 1.14); Incidence of vertebral fracture: no difference (RR 0.82; 95% CI 0.53 to 1.26); Incidence of non-vertebral fracture: no difference (RR 1.05; 95% CI 0.86 to 1.29) |
| 91 Humalda et al. 2020 | randomised controlled · 36 participants | Capsules containing potassium chloride, sodium chloride, or placebo; 3 g/d potassium chloride or 3 g/d sodium chloride; vs. Placebo (randomized, blinded, crossover) | plasma phosphate: improved (from 1.10 ± 0.19 to 1.15 ± 0.19 mmol/L, P = 0.004); tubular maximum of phosphate reabsorption: improved (from 0.93 ± 0.21 to 1.01 ± 0.20 mmol/L, P < 0.001); FGF23: improved (114.3 [96.8-135.0] to 108.5 [93.5-125.9] RU/mL, P = 0.01) |
| 132 Zhang et al. 2022 | cohort study · 392 participants | dietary potassium (assessed by FFQ); 24 months; vs. higher vs. lower potassium intake | knee joint structures: no difference |
Potassium and Stroke: Human Studies
In stroke prevention, the results differ depending on the form and use of potassium. A randomized controlled trial with a salt substitute of potassium chloride and sodium chloride found fewer recurrent strokes and fewer hemorrhagic strokes in stroke survivors in northern China 20. A systematic review of the DASH diet, which besides more potassium also includes calcium, magnesium, fiber and less sodium, could not establish an effect on stroke risk 6. In people who newly took furosemide, additional potassium in an observational study was not associated with strokes 139. The evidence is low, because only one controlled study is available and the remaining findings come from mixed preparations or observational data. It remains open whether potassium alone, independent of salt substitution or accompanying nutrients, lowers stroke risk.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 6 Bensaaud et al. 2025 | systematic review · 1,397 participants | DASH diet as a dietary component with increased potassium; Intervention 16 weeks to 12 months, follow-up 16 weeks to 18 months; vs. No intervention/usual care, minimal intervention, or other diets | Stroke: no difference (no strokes in either group) |
| 20 Ding et al. 2025 | randomised controlled · 15,249 participants | Salt substitute with 75% sodium chloride and 25% potassium chloride vs regular salt; median 61.2 months; vs. regular salt | recurrent stroke: improved (RR, 0.86; 95% CI, 0.77-0.95; P = .005); hemorrhagic stroke: improved (relative reduction, 30%; P = .002) |
| 124 Li et al. 2026 | study · 15,249 participants | Potassium-enriched salt substitute replacing regular salt; lifetime horizon; vs. regular salt | recurrent stroke events: improved (454,559 recurrent stroke events (a 3·7% reduction)); stroke deaths: improved (482,632 stroke deaths (a 15·0% reduction)) |
| 139 Pham et al. 2026 | cohort study | Empiric potassium supplementation; vs. Potassium vs. no potassium at furosemide initiation | Stroke: no difference (1.03 (1.00-1.06)) |
Potassium: Further Outcomes in Studies
Urinary potassium excretion increased with potassium chloride supplements 4177 and after a short medical nutrition counseling 117. In dialysis patients with predialysis hyperkalemia, sodium zirconium cyclosilicate maintained normokalemia better than placebo over twelve months 24, and bananas at the start of hemodialysis kept serum potassium higher during dialysis and made hypokalemia less common 48. The evidence is moderate: A meta-analysis and numerous controlled studies are available, but the forms and populations examined are very heterogeneous. Potassium chloride, potassium citrate, potassium bicarbonate, potassium gluconate, potassium aspartate, potassium from food as well as potassium binders, partly as mixed preparations with sodium or magnesium, were examined.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 6 Bensaaud et al. 2025 | systematic review · 1,397 participants | DASH diet as a dietary component with increased potassium; Intervention 16 weeks to 12 months, follow-up 16 weeks to 18 months; vs. No intervention/usual care, minimal intervention, or other diets | All-cause mortality: no difference (no deaths) |
| 9 Ravichagua et al. 2025 | meta-analysis · 803 participants | Oral potassium supplements (salt form not reported); Median 4 weeks; vs. Placebo, sodium chloride, or no treatment | Any adverse event (RR 2.41); Total withdrawals: worsened (RR 1.32); AE-related withdrawals (RR 1.28) |
| 15 Brand et al. 2022 | systematic review | Potassium-containing low-sodium salt substitutes (LSSS) replacing regular salt; vs. Regular salt or no active intervention | Change in blood potassium, hyperkalaemia, hypokalaemia: unclear |
| 17 Zhang et al. 2025 | randomised controlled · 20,996 participants | Sodium-reduced potassium-enriched salt substitute; mean follow-up 4.7 years; vs. continued regular salt use | total stomach cancer: no difference (RR 0.77, 95% CI 0.54 to 1.08); adjudicated fatal stomach cancer: improved (RR 0.66 (95% CI 0.44 to 1.00)); unadjudicated non-fatal stomach cancer: no difference (RR 0.88 (95% CI 0.56 to 1.37)) |
| 19 Haghdoost et al. 2024 | randomised controlled · 20,995 participants | Salt substitute with 75% sodium chloride and 25% potassium chloride; mean follow-up 4.7 years; vs. regular salt (100% sodium chloride) | Headache frequency: no difference (RR 1.04, 95% CI: 0.93, 1.16, p = 0.48); Headache severity: no difference (p = 0.90) |
| 21 Lin et al. 2026 | randomised controlled · 14,989 participants | Real-time AI-enabled ECG alert in the electronic health record; 6 months (2022); vs. Physicians without alerts (control group) | Hyperkalemia-related treatment within 3 hours (all patients): no difference (8.0% vs. 7.7%; hazard ratio 1.05; 95% CI 0.94-1.17; p = 0.420); Hypokalemia-related treatment within 3 hours: no difference (2.1% vs. 2.4%; hazard ratio 0.91; 95% CI 0.74-1.13; p = 0.392); Hyperkalemia-related treatment among AI-ECG-identified patients: improved (69.1% vs. 41.6%; hazard ratio 2.23; 95% CI 1.44-3.46; p < 0.001) |
| 25 O'Brien et al. 2024 | randomised controlled · 1,690 participants | Potassium supplementation (potassium chloride) triggered by serum potassium threshold; Supplement only if serum potassium <4.5 mEq/L (tight) vs <3.6 mEq/L (relaxed); First 120 hours after CABG or until discharge; vs. Tight vs relaxed potassium control | In-patient mortality: no difference; Length of stay: no difference; Per-patient cost for purchasing and administering potassium: improved (mean difference, $111.89 [95% CI, $103.60-$120.19]; P <.001) |
| 30 Hao et al. 2025 | randomised controlled · 309 participants | Free medically tailored groceries high in fibre or healthy fats; 12-week intervention, follow-up up to 12 months; vs. Usual care without grocery provision | Potassium intake during intervention: improved (+ 279 mg (95%CI 0 to 558 mg)); Potassium intake at follow-up: no difference |
Further studies in this area: 31 32 33 34 37 39 40 41 42 44 45 46 47 48 49 50 51 52 54 55 56 58 59 60 63 64 65 66 67 68 69 70 77 78 79 80 84 85 86 87 88 89 90 94 98 100 102 103 106 110 111 112 117 118 120 121 123 124 126 127 130 131 132 134 135 136 139
4. How Is Potassium Dosed? Preparation, Dose and Duration in Studies
The studies used potassium chloride, potassium citrate, potassium bicarbonate, potassium gluconate, potassium aspartate as well as potassium from food, partly as salt substitutes with sodium chloride or as combination products with magnesium. Some investigations used potassium binders such as patiromer or sodium zirconium cyclosilicate in hyperkalemia. The doses, durations and preparations differ greatly and are shown in the table.
| Preparation or form | Dose | Duration | Study |
|---|---|---|---|
| Sodium-reduced potassium-enriched salt substitute | — | mean follow-up 4.7 years | 17 |
| Salt substitute (potassium chloride-containing) vs. regular salt | — | 5 years | 18 |
| Salt substitute with 75% sodium chloride and 25% potassium chloride | — | mean follow-up 4.7 years | 19 |
| Salt substitute with 75% sodium chloride and 25% potassium chloride vs regular salt | — | median 61.2 months | 20 |
| Real-time AI-enabled ECG alert in the electronic health record | — | 6 months (2022) | 21 |
| Multifaceted intervention including potassium-enriched low-sodium salt substitute | — | 6-month active phase, follow-up to 12 months | 22 |
| Sodium zirconium cyclosilicate (SZC), potassium binder | Starting dose 5 g once daily on non-dialysis days, titrated as needed | — | 23 |
| Sodium zirconium cyclosilicate (SZC), a potassium binder | 5 g once daily on nondialysis days, titrated weekly over 4 weeks between 0 and 15 g | up to 12 months (normokalemia at 12 months reported) | 24 |
| Potassium supplementation (potassium chloride) triggered by serum potassium threshold | Supplement only if serum potassium <4.5 mEq/L (tight) vs <3.6 mEq/L (relaxed) | First 120 hours after CABG or until discharge | 25 |
| Potassium-increasing treatment (form not specified) plus standard care | Uptitration to high-normal plasma potassium (increase 0.3 mmol/L) | median follow-up 3.3 person-years | 26 |
| Potassium supplementation, mineralocorticoid receptor antagonist, or both plus dietary guidance | Target plasma potassium 4.5–5.0 mmol/l | Median follow-up 39.6 months | 27 |
| Salt substitute with 70% sodium chloride and 30% potassium chloride replacing all home salt | — | until end of trial (duration not reported) | 28 |
| Free medically tailored groceries high in fibre or healthy fats | — | 12-week intervention, follow-up up to 12 months | 30 |
| Legume-based DASH diet (dietary potassium) | — | 16 weeks | 31 |
| Tablets: T1 supplement, T2 placebo, T3 magnesium, T4 magnesium plus potassium | — | 60 days follow-up | 32 |
5. Is Potassium Safe? Side Effects in Studies
In a meta-analysis, adverse events and discontinuations occurred more frequently with potassium 9. Details are shown in the table.
| Study | Reported side effects |
|---|---|
| 2 Zirino et al. 2025 | Adverse event data limited, no significant differences in total AEs; mortality data sparse (one death in placebo group) |
| 6 Bensaaud et al. 2025 | Adverse effects were a secondary outcome, not reported in the abstract |
| 7 Poorolajal et al. 2017 | No important adverse effects; described as safe |
| 9 Ravichagua et al. 2025 | Adverse events more frequent (RR 2.41); more withdrawals (RR 1.32) |
| 15 Brand et al. 2022 | Hyperkalaemia and hypokalaemia assessed as safety outcomes |
| 20 Ding et al. 2025 | no significant difference in hyperkalemia (RR, 1.01; 95% CI, 0.74-1.38; P = .96) |
| 22 Du et al. 2026 | serious adverse events 2.8% vs 2.3% |
| 23 Fishbane et al. 2026 | Edema 5% vs 5%, heart failure 5% vs 5%, hypertension 9% vs 8% |
| 24 Fishbane et al. 2025 | Serious adverse events 38.6% (SZC) vs 37.6% (placebo); hypokalemia 3.0% vs 1.4% |
| 25 O'Brien et al. 2024 | No increase in dysrhythmias or adverse clinical outcomes in relaxed group |
| 27 Jøns et al. 2025 | Hospitalization for hyperkalemia or hypokalemia similar in both groups |
| 36 Reddy et al. 2014 | drug intolerance in 61 patients within 1 month |
6. What Remains Open: Limits of the Evidence
- The studies differ greatly in salt form, dose, duration and population, which makes a direct comparison difficult.
- Many investigations on kidney and cardiovascular system are small and short, partly with combination products.
- For potassium from food, the blood pressure data are inconsistent; studies with endpoints such as heart attack or stroke are still pending.
- For muscle, diabetes and bone, only a few controlled studies with different forms are available.
- The transferability to healthy individuals is limited, since many findings were obtained in patients with hyperkalemia, dialysis or diabetes.
7. Bottom Line: What Is Established About Potassium
Potassium is an essential mineral and electrolyte that has been studied in humans in various forms and preparations. A blood pressure reduction is most evident with supplements and potassium-enriched salt substitutes, while the data on potassium from food are inconsistent. In hyperkalemia on dialysis, potassium binders reduce hyperkalemia events, and most also lower the potassium level. For cardiovascular endpoints, the evidence is moderate, for muscle, diabetes and bone it is low; many studies are small, short or investigated combination products. The results apply in each case only to the potassium form and preparation studied.
Frequently Asked Questions
How well has Potassium been studied in humans?
We evaluated 165 human studies on Potassium, including 126 randomised controlled trials and 16 meta-analyses or systematic reviews; the controlled studies include 120,229 participants in total. As of 4 October 2026.
Does Potassium help with blood pressure? What the studies show
Does Potassium help with cardiovascular? What the studies show
Does Potassium help with kidney? What the studies show
Does Potassium help with diabetes? What the studies show
Does Potassium help with muscle? What the studies show
Does Potassium help with bone? What the studies show
Does potassium lower blood pressure?
Several meta-analyses of controlled studies show that increased potassium intake lowers blood pressure, especially in hypertension and as a supplement 3478911; potassium-containing salt substitutes also lowered it 5. Other controlled studies found no confirmed difference, for example with a higher-potassium diet in kidney disease 101 or after a single potassium-rich meal 99. The results therefore depend on form, preparation and population.
Which potassium forms were studied?
Potassium chloride, potassium citrate, potassium bicarbonate, potassium gluconate, potassium aspartate and potassium from food were studied, partly as combination products with sodium chloride or magnesium. Some studies used potassium binders such as patiromer or sodium zirconium cyclosilicate in hyperkalemia. The results apply in each case only to the form and preparation studied.
How safe is potassium in the studies?
A salt substitute made of potassium chloride and sodium chloride did not lead to hyperkalemia more frequently than normal salt 20, and a potassium-increasing treatment did not lead to hospital admissions due to hyperkalemia or hypokalemia more frequently 27. In a meta-analysis, adverse events and discontinuations occurred more frequently with potassium 9. With the potassium binder sodium zirconium cyclosilicate, hypokalemia occurred somewhat more frequently in dialysis patients than with placebo 24.
Are there studies on potassium in diabetes?
There are five controlled studies that do not give a consistent picture. A randomized controlled study with a mixture of olive leaf extract and potassium found decreasing fasting insulin and HOMA values; fasting glucose and HbA1c remained unchanged 65. The evidence is low, since forms, mixtures and populations vary greatly.
What do the studies on potassium and stroke show?
A randomized controlled study with a salt substitute made of potassium chloride and sodium chloride found fewer recurrent strokes and fewer hemorrhagic strokes in stroke survivors in northern China 20. A systematic review on the DASH diet, which includes further nutrient changes in addition to more potassium, could not confirm any effect on stroke risk 6. The evidence is low, since only one controlled study is available and the remaining findings come from combination products or observational data.
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Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.