Link Between High Potassium and Cardiovascular Disease

Can You Get Too Much Potassium?

Potassium is a critical nutrient that the body needs for supporting the healthy functioning of the nerves, cells, and muscles.(1,2,3) A normal blood potassium level should be between 3.5 and 5.0 millimoles per liter (mmol/L).(4) Ideally, people should be getting around 4700 milligrams of potassium each day as it is naturally found in many foods, including:(5)

If there is excess potassium in the blood, your kidneys are able to successfully filter it out through your urine. Sometimes though, the body is unable to eliminate the extra potassium that you consume. This leads to a build-up of potassium in the blood, a condition known as hyperkalemia.(6,7)

Link Between High Potassium and Cardiovascular Disease

Cardiovascular disease is an umbrella term used to refer to a number of heart-related problems. These include:

According to the US Centers for Disease Control and Prevention (CDC), cardiovascular disease is one of the leading causes of death in the United States, and it is estimated that cardiovascular disease kills one American every 37 seconds.(8)

Some of the common risk factors that increase the likelihood of developing cardiovascular disease include high blood pressure, smoking, diabetes, high blood cholesterol, lack of physical activity, and obesity.

If you are at a risk of developing cardiovascular disease, it is essential to consult your doctor and to have a plan to help manage these risk factors.

Additionally, high potassium blood levels have also been linked to an increased risk of cardiovascular disease.

Staying within the healthy potassium blood level range is needed for the body to support healthy electric signaling in the heart. Healthy levels of potassium also help your muscles function properly, including the muscles that control your breathing and your heartbeat.

However, if you have too much potassium in the blood, a condition known as hyperkalemia, it can create many problems for your health and even prove to be life-threatening if left untreated.

The condition of hyperkalemia is more commonly observed in people who have underlying health conditions, such as congestive heart failure.(9) Furthermore, the medications that are used for treating cardiovascular diseases, such as beta-blockers and ACE inhibitors, are also known to increase the risk of hyperkalemia because they cause the kidneys to hold on to the excess potassium.(10)

If left untreated, high potassium levels in the bloodstream can further aggravate underlying heart problems or even cause new heart problems. Hyperkalemia is often known to cause an irregular heartbeat, a condition known as arrhythmia. Arrhythmias can lead to a heart attack, or even death if it is not diagnosed in time and treated.(11)

Most people with high potassium do not notice any symptoms or may experience some minor signs that are quite similar to other conditions. This is why the symptoms often go unnoticed and unreported. People who do notice symptoms may experience:

  • Nausea and/or vomiting
  • Muscle weakness
  • Tingling sensation (feeling like pins and needles), especially on the hands and feet
  • Numbness
  • Diarrhea
  • Abdominal cramps or pain
  • Weak or irregular heartbeat (heartbeat might be too fast or too slow, or just irregular)
  • Shortness of breath
  • Fainting

If you have cardiovascular disease, it is very important that you monitor your potassium blood levels and keep them in the normal range.

For people with heart conditions, it is also necessary to make sure that potassium blood levels to do fall below the normal range. This is because low blood potassium can cause the blood vessels in the heart to harden.(12) Low potassium levels have also been linked to:

It is best to consult your doctor or a dietitian to ensure you are getting just the right amount of potassium in your diet, especially if you already have cardiovascular disease or are at a high risk of developing heart disease.(13)

How to Keep your Potassium Blood Levels in the Normal Range?

People with cardiovascular disease need to make extra efforts to maintain their potassium blood levels within the normal range. Your doctor is likely to recommend that the first step towards this is to modify your diet, especially if you are at risk of developing hyperkalemia. You should talk to a dietitian or nutritionist to find out more about what types of high potassium foods you should restrict or avoid altogether. Some of these high potassium foods that should be avoided or limited include:

  • Tomatoes
  • Potatoes
  • Avocados
  • Asparagus
  • Cooked spinach
  • Kiwi
  • Oranges
  • Winter squash
  • Cantaloupe
  • Nectarines
  • Bananas
  • Dried fruits like prunes and raisins

At the same time, you should avoid using salt substitutes. Keep an eye on the seasonings you are using as they tend to have a high amount of potassium. Your doctor may also advise you to change your milk products for other dairy alternatives like rice milk.(14,15) If you are taking any supplements that contain potassium, you may need to stop taking those. However, always discuss with your doctor before taking or stopping any supplements and other medications.

Some good low potassium foods that you should include in your diet if you are watching your potassium levels are as follows:

  • Apples
  • Green beans
  • Berries
  • Mashed potatoes
  • Onions
  • Cranberries
  • Zucchini
  • Bell peppers
  • Grapes
  • Mushrooms
  • Summer squash
  • Peaches
  • Watermelon

Treatment of High Blood Potassium Levels

Maintaining the blood potassium levels is necessary to avoid having heart-related problems and complications. Your doctor will recommend the following ways of treating high potassium levels:(16)

  • Diuretics for flushing out potassium through urination
  • Dialysis to filter your blood
  • Potassium binders are medications that bind to the extra potassium in the bowel and are then removed through stool.
  • Following a low potassium diet

Conclusion

Consuming foods rich in potassium can help protect your heart, but consuming too much potassium can increase the blood levels of potassium. This condition is known as hyperkalemia, and if left untreated, it can cause various health conditions, including arrhythmias.

People with congestive heart failure or other types of heart-related diseases are at a greater risk of developing hyperkalemia. The risk is higher if you are also taking medications for your heart condition, such as ACE inhibitors and beta-blockers.

A high blood potassium level can interfere with the electric signaling in the heart, thus causing life-threatening complications. This is why it is so essential that you do not ignore the symptoms of hyperkalemia and consult your doctor at the earliest if you suspect you may have high potassium. If you are at a risk of or already have cardiovascular disease, you must talk to your doctor or a dietitian to understand how much potassium you should be having in your diet.

References:

  1. Lester, G.E., Jifon, J.L. and Makus, D.J., 2010. Impact of potassium nutrition on food quality of fruits and vegetables: A condensed and concise review of the literature. Better Crops, 94(1), pp.18-21.
  2. Weaver, C.M., 2013. Potassium and health. Advances in Nutrition, 4(3), pp.368S-377S.
  3. He, F.J. and MacGregor, G.A., 2001. Beneficial effects of potassium. Bmj, 323(7311), pp.497-501.
  4. National Kidney Foundation. 2020. What Is Hyperkalemia?. [online] Available at: <https://www.kidney.org/atoz/content/what-hyperkalemia> [Accessed 28 October 2020].
  5. Ods.od.nih.gov. 2020. Office Of Dietary Supplements – Potassium. [online] Available at: <https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/> [Accessed 29 October 2020].
  6. Parham, W.A., Mehdirad, A.A., Biermann, K.M. and Fredman, C.S., 2006. Hyperkalemia revisited. Texas Heart Institute Journal, 33(1), p.40.
  7. Evans, K.J. and Greenberg, A., 2005. Hyperkalemia: a review. Journal of Intensive Care Medicine, 20(5), pp.272-290.
  8. Centers for Disease Control and Prevention. 2020. Heart Disease Facts | Cdc.Gov. [online] Available at: <https://www.cdc.gov/heartdisease/facts.htm> [Accessed 29 October 2020].
  9. Obialo, C.I., Ofili, E.O. and Mirza, T., 2002. Hyperkalemia in congestive heart failure patients aged 63 to 85 years with subclinical renal disease. American Journal of Cardiology, 90(6), pp.663-665.
  10. Gehr, T.W. and Sica, D.A., 2001. Hyperkalemia in congestive heart failure. Congestive Heart Failure, 7(2), pp.97-100.
  11. Yap, V., Patel, A. and Thomsen, J., 1976. Hyperkalemia with cardiac arrhythmia: Induction by salt substitutes, spironolactone, and azotemia. Jama, 236(24), pp.2775-2776.
  12. Meneely, G.R. and Battarbee, H.D., 1976. High sodium-low potassium environment and hypertension. The American journal of cardiology, 38(6), pp.768-785.
  13. Roden, D.M. and Iansmith, D.H., 1987. Effects of low potassium or magnesium concentrations on isolated cardiac tissue. The American journal of medicine, 82(3), pp.18-23. Demigné, C., Sabboh, H., Rémésy, C. and Meneton, P., 2004. Protective effects of high dietary potassium: nutritional and metabolic aspects. The Journal of nutrition, 134(11), pp.2903-2906.
  14. Anderson, J., Young, L. and Long, E., 2002. Potassium and health. Food and nutrition series. Health; no. 9.355.
  15. Sterns, R.H., Grieff, M. and Bernstein, P.L., 2016. Treatment of hyperkalemia: something old, something new. Kidney international, 89(3), pp.546-554.

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