A small change in salt could prevent millions of deaths linked to high blood pressure

Swapping part of the sodium in salt for potassium could help prevent almost 3 million deaths each year worldwide, according to a new estimate. The biggest impact would come from a wide adoption of the substitute, including the salt used in processed foods and at home.

Researchers at The George Institute for Global Health calculated how the change could affect 193 countries. In their broadest model, the shift could also prevent about 10 million new cases of cardiovascular and kidney disease every year.

The approach addresses the problem from both ends. Too much sodium and too little potassium can raise blood pressure, which in turn increases the risk of stroke, heart attack, and kidney disease.

Regular table salt is sodium chloride. In a potassium-enriched version, some of the sodium is replaced with potassium chloride, so people using the same amount would generally take in less sodium and more potassium than they would with ordinary salt.

In research published in Nature Health, the team examined several possible rollout strategies. Those scenarios ranged from broad changes across the food supply to a version aimed mainly at people already being treated for high blood pressure.

The nearly 3 million deaths figure came from the most expansive scenario. More limited approaches also offered benefits, but the results depended on who used the substitute, where their sodium came from, and how much their diets changed in practice.

High blood pressure can damage both the heart and the kidneys, which is why prevention matters on both fronts.

Where most sodium comes from packaged foods, changing only the salt used in home cooking would cover only part of a person’s intake.

That is why food manufacturers could play a major role in countries where processed foods provide most of the sodium in the diet. In places where people rely more on salt added during cooking, making the substitute available and affordable in local shops could reach more of the salt they consume.

Potassium-enriched salt also raises safety concerns. People with kidney problems, or those taking medicines that increase potassium levels, may not be able to clear the extra potassium safely. The World Health Organization’s recommendation for lower-sodium table salt excludes people with kidney impairment or other conditions that affect potassium excretion.

The researchers weighed risks alongside benefits, but population averages cannot show whether the substitute is right for any one person. Clear labeling and medical supervision would be important if access expands, especially for people who need to watch their potassium intake.

The study estimates what a coordinated switch could achieve, rather than counting deaths prevented by a program already underway. Its value lies in identifying where health authorities and food producers could make the greatest difference, and which groups would need added protections.

If you are interested in this topic, please read articles about Salt and heart health: does less really mean more?, and Why bananas can lower blood pressure effectively.

For more information, please see articles about The DASH diet is a simple way to lower high blood pressure, and Nutrition and chronic kidney disease: a guide to eating well.

Source: The George Institute for Global Health.