The exquisite link between potassium homeostasis regulation and cardiovascular health: exploration and analysis

Cardiovascular diseases (CVDs) are the leading global cause of mortality, with potassium homeostasis playing a fundamental role in their pathophysiology. Tightly regulated potassium ions (K + ) are essential for cardiac electrophysiological stability, and their dysregulation is a critical driver of disorders, particularly cardiac arrhythmias. Systemic potassium homeostasis is maintained by a complex network involving dietary intake, renal and intestinal handling, neuromodulatory control, skeletal muscle buffering and membrane ion channel activity, et al, which together determine extracellular and intracellular potassium homeostasis. This review summarizes the physiological mechanisms underlying potassium homeostasis and critically examines how potassium imbalance contributes to CVDs, with a primary focus on arrhythmia-related pathophysiology. By integrating experimental and clinical evidence, we highlight clinically relevant mechanisms and potential therapeutic strategies aimed at optimizing potassium homeostasis, thereby providing a conceptual framework to improve CVDs prevention and management.