Hyperkalemia is a potential serious side effect of certain blood pressure medications, including angiotensin II receptor blockers (ARBs) and angiotensin converting enzyme inhibitors (ACE inhibitors).
However, consuming a diet high in potassium-rich foods is often recommended to help lower high blood pressure. This creates a potential safety issue when patients are also taking ARBs or ACE inhibitors to manage blood pressure.
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Research presented at the American Heart Association (AHA)’s Hypertension Scientific Sessions 2026 conference examined whether following a potassium-rich Dietary Approaches to Stop Hypertension (DASH) diet was associated with an increased risk of elevated serum potassium over a 12-week period.
They found that the DASH diet did not raise blood potassium to unsafe levels.
The abstracts presented at the conference are considered preliminary until they are published in a peer-reviewed scientific journal.
Participants in the study did not experience any significant increase in blood potassium after following the potassium-rich DASH diet for 12 weeks.
Researchers analyzed data from 356 Black adults from the greater Boston area who were participating in GoFresh and GoFreshRx trials. 70% of participants were women, and the average age was 53 years.
Participants either received DASH-patterned groceries or a monetary stipend to purchase appropriate food for the eating plan, which provided around 4,700 milligrams (mg) of potassium per day.
At the start of the study, the average serum potassium at baseline was 4.16 millimoles per liter (mmol/L) in the group receiving groceries and 4.18 mmol/L in the group purchasing their own food.
After 12 weeks, the study authors noted “no significant increase in potassium levels” in either group.
David Rhee, MD, board certified cardiologist with Manhattan Cardiology in NYC, and contributor to LabFinder.com, told Medical News Today:
“The kidney is unmatched in its ability to self-regulate the excretion of water and electrolytes. Yes, sometimes the kidney can get things wrong too, especially if we add medications or diseases to the mix, but this study further supports that the kidney is able to handle a dietary potassium load by appropriately increasing potassium secretion even in patients with high blood pressure and medications that work through the kidneys.”
Rhee, who was not involved in the study, added that “food-based potassium is absorbed into the bloodstream more slowly than potassium chloride supplements.”
Cheng-Han Chen, MD, board certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, also spoke with MNTabout the research.
“While we have traditionally exercised caution before recommending the DASH diet in patients who are prescribed ACE inhibitors, angiotensin receptor blockers, or potassium-sparing diuretics, these results show that those patients could likely adopt the DASH diet without significant concern for harm,” said Chen, who was also not involved in the study.
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Those following the DASH diet did not experience any dangerous changes in kidney function.
However, the researchers noted in the press release that “future research should focus on participants with suboptimal kidney function.” Kidney disease can increase serum potassium due to a reduced ability to effectively filter potassium.
This is more common with advanced kidney problems, but this study did not include participants with stage 4 or 5 kidney disease.
They also did not include people with higher-than-average baseline serum potassium.
“In general, people with advanced chronic kidney disease or known chronic high potassium levels should still avoid a high potassium diet,” cautioned Chen.
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“Once we enter into advanced kidney disease territory (stage 4-5), hyperkalemia poses a significant risk and patients (on or off these blood pressure medications) should not deliberately increase their potassium intake. If anything, they will often need to decrease the potassium intake,” Rhee added.
Participants in the study had around 4,700 mg of potassium each day. We asked Rhee whether this amount of potassium daily was realistic and appropriate for most people with high blood pressure.
“4.7 grams [4,700 mg] of potassium is really, really hard to achieve. Most of us take in about 2 to 3 grams [2,000 to 3,000 mg] per day. We should still try to strive for 3 to 5 grams [3,000 to 5,000 mg] (via leafy greens, potatoes, legumes, bananas, avocados, and salmon),” he explained.
Rhee added that “[t]he best diet is the one you can sustain, and I recommend patients who are committed to optimizing their diet for health benefits partner with a nutritionist […] to have the best chance for success.”
Rhee also advised that people with a history of any of the following should seek out an individualized diet with a healthcare professional:
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As the study found that increasing potassium intake through the DASH diet did not cause dangerous increases in blood potassium, we wanted to know whether this would change how healthcare professionals might think about recommending potassium-rich foods to patients taking blood pressure medication.
“As long as the kidney function is not impaired, I have already been recommending potassium-rich fruits and vegetables to my patients with high blood pressure with or without medications,” said Rhee. “But now I feel more confident and will likely cite this study to reassure the patient.”
“It’s not just the blood pressure medications that can raise potassium levels. There is a long list of meds that pose a risk of hyperkalemia, especially in combination with each other or with a specific disease state. With any significant lifestyle change (even if it’s proposed to be a healthy one), I always advise you discuss it with your healthcare provider first.”
— David Rhee, MD
“The study findings reinforce what a lot of clinicians have already been doing, but now we can feel more confident that our advice is evidence-based. I commend the researchers,” Rhee concluded.
