Is the DASH diet safe for patients on potassium-raising drugs?

Clinical takeaway: Consider recommending a DASH eating pattern to Black adults with an eGFR of at least 30 and serum potassium levels of 3.5 to 5.0 mmol/L, even when they are taking ACE inhibitors, ARBs, potassium-sparing diuretics, beta blockers, or NSAIDs.

The Dietary Approaches to Stop Hypertension (DASH) diet is a well-established lifestyle intervention for lowering blood pressure, but its emphasis on potassium-rich foods can make clinicians hesitant to recommend it to patients receiving medications that may increase potassium levels. To explore this concern, investigators presented a pooled analysis of the GoFresh and GoFreshRx randomized trials, which enrolled 356 Black adults in the Boston area with systolic blood pressure of 120 to under 150 mm Hg, with or without treated hypertension.

Participants received either weekly DASH-patterned groceries designed to provide approximately 4,700 mg of potassium daily or self-directed monetary stipends for 3 months. Mean age was 53 years, and 47% had an eGFR below 90 mL/min/1.73 m², including 7% with an eGFR of 30 to 60.

The effect of the grocery intervention on serum potassium did not differ according to use of ACE inhibitors/ARBs, potassium-sparing diuretics, beta blockers, or NSAIDs. Similarly, baseline kidney function did not appear to influence the relationship between the intervention and potassium levels. Overall, greater dietary potassium intake was not associated with hyperkalemia in participants taking potassium-raising medications.

The investigators concluded, “While these findings confirm the safety of DASH diet recommendations for many adults, they should be confirmed among adults with higher serum potassium levels and advanced renal impairments.”

Source: Budu M, et al. (2026 Oct 8) American Heart Association Hypertension Scientific Sessions 2026. Poster presentation. Effects of DASH-Patterned Groceries on Serum Potassium Levels in Black Adults Taking Potassium-Raising Medications