DASH Diet Does Not Increase Hyperkalemia Risk in Adults on Antihypertensive Therapy: Study

Increased consumption of potassium-rich foods that are part of the Dietary Approaches to Stop Hypertension (DASH) diet did not raise blood potassium to dangerous levels in people taking medications to lower their blood pressure, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2026. The meeting is in Arlington, Virginia, October 7-11, 2026, and is the premier scientific exchange focused on recent advances in basic and clinical research on high blood pressure and its relationship to cardiac and kidney disease, stroke, obesity and genetics.

A high level of potassium in the blood, known as hyperkalemia, can cause problems with the heart’s rhythm. People with impaired kidney function due to chronic kidney disease are at increased risk of hyperkalemia. Some medications prescribed to treat Type 2 diabetes, heart failure and blood pressure may lead to more potassium in the blood than the kidneys can remove.

The DASH diet plan is well-established to help manage blood pressure and emphasizes healthy food sources, such as fruits, vegetables, whole grains, nuts and low-fat dairy products, and limits red meat, salt, and added sugars and sugary beverages. This dietary pattern aligns with the American Heart Association’s 2026 Dietary Guidance to Improve Cardiovascular Health.

“The DASH diet is a well-known, proven nutrition pattern that is known to improve blood pressure,” said Marian Budu, M.B.B.S., M.P.H., a clinical research coordinator on the GoFresh Trials at Beth Israel Deaconess Medical Center in Boston, and the presenting author of the study. “However, dangerous potassium levels can occur in people taking blood pressure medications and NSAIDs. Knowing that the DASH diet did not increase blood potassium levels in this population with normal baseline potassium levels provides assurance that the DASH diet can be prescribed to a wide range of people.”

This study was a secondary analysis of the GoFresh and GoFresh Rx randomized trials that enrolled Black adults in the greater Boston area with high blood pressure who were and were not taking medications to lower their blood pressure.

For this study, the researchers examined three classes of blood pressure medications: angiotensin-converting enzyme inhibitors (ACEi), angiotensin receptor blockers (ARBs), potassium-sparing diuretics and beta blockers, as well as NSAIDs. The GoFresh trials enrolled participants with varying degrees of kidney function, and it was important to determine if there would be any changes in potassium levels in those with lower kidney function.

What are the key findings of the study?

• The analysis found that eating more potassium-rich foods in the DASH diet did not increase potassium levels to dangerous levels among individuals taking ACEis, ARBs, potassium-sparing diuretics and beta blockers, and NSAIDs.
• At the beginning of the study, the average serum potassium level in the group that received DASH-diet groceries was normal at 4.16 mmol/L and 4.18 mmol/L in the group that purchased their own groceries.
• Among the group prescribed the DASH-diet grocery delivery program, serum potassium levels did not differ among the subgroups taking ACEi/ARBs, potassium-sparing diuretics, beta-blockers or NSAIDs.
• There was no significant increase in potassium levels, regardless of whether participants were assigned to the grocery intervention or the monetary stipend group.

“The original GoFresh trial was successful in improving blood pressure when following the DASH diet,” said Kevin Volpp, M.D., Ph.D., a volunteer expert with the American Heart Association and scientific lead of the Association’s Health Care by Food initiative. “This follow-up study is important because it confirms that significant increases in potassium did not occur with the DASH diet, even for patients on medications that might contribute to increased potassium levels. Managing and monitoring potassium levels is key because they have a direct impact on heart function.” Dr. Volpp, who was not involved in this study, is the Ralph and Beth Johnston Muller Director, Penn Center for Health Incentives and Behavioral Economics, and Mark V. Pauly President’s Distinguished Professor, Perelman School of Medicine and the Wharton School at the University of Pennsylvania in Philadelphia.

A limitation of the study is that it did not include people with stage 4 or stage 5 kidney disease, or those with higher-than-normal potassium levels at the beginning of the study. Additionally, the study population only included Black individuals living in Boston, so the results may not be generalizable to the general population.

The authors noted that future research should focus on participants with suboptimal kidney function and those with higher potassium levels at baseline.

Reference:

Potassium-rich DASH diet found safe for adults taking common blood pressure medications, American Heart Association: Meeting American Heart Association Hypertension Scientific Sessions 2026