A secondary analysis of the GoFresh and GoFreshRx randomized trials has found that increased consumption of potassium-rich foods, as part of the Dietary Approaches to Stop Hypertension (DASH) diet, did not raise blood potassium to dangerous levels in adults taking medications to lower blood pressure. The preliminary research was presented at the American Heart Association's Hypertension Scientific Sessions 2026 in Arlington, Virginia.
High blood potassium, or hyperkalemia, can disrupt heart rhythm and is a particular concern for individuals with impaired kidney function. Certain blood pressure medications, including ACE inhibitors, ARBs, potassium-sparing diuretics, and beta blockers, as well as NSAIDs, can increase potassium levels. This has raised questions about whether the DASH diet, which encourages potassium-rich foods like fruits, vegetables, whole grains, nuts, and low-fat dairy, might be risky for those on such medications.
"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. "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."
The analysis included 356 Black adults with an average age of 53, 70% of whom were women. Participants had systolic blood pressure between 120 and less than 150 mm Hg and diastolic blood pressure less than 100 mm Hg. Half received three months of weekly DASH-patterned groceries and nutrition counseling, while the other half received a monetary stipend to buy their own groceries. Blood potassium was measured at baseline and after 12 weeks. The average baseline serum potassium was normal at 4.16 mmol/L in the grocery group and 4.18 mmol/L in the stipend group. The study found no significant increase in potassium levels, regardless of medication class or group assignment. The DASH diet aligns with the American Heart Association's 2026 Dietary Guidance to Improve Cardiovascular Health.
"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."
The researchers noted limitations: the study did not include people with stage 4 or stage 5 kidney disease or those with higher-than-normal potassium levels at baseline, and the population was limited to Black individuals in Boston, so results may not be generalizable. Future research should focus on participants with suboptimal kidney function and higher baseline potassium. The findings are considered preliminary until published as a full manuscript in a peer-reviewed journal. The abstracts will be published in the Hypertension Scientific Sessions 2026 Supplement of the Hypertension journal.
This research provides important reassurance that the DASH diet can be safely recommended for a wide range of people with high blood pressure, including those on medications that affect potassium. It supports the broader implementation of dietary interventions to manage blood pressure and reduce cardiovascular risk. Additional resources include the American Heart Association news release Following 9 key steps for a lifetime of eating well can support heart health and Reducing sodium in everyday foods may yield heart-health benefits across populations.
