Salt Substitutes Reduce High Blood Pressure Risk By 40%

  • Using salt substitutes may reduce the risk of developing high blood pressure, a new study finds.
  • Researchers found that those using salt substitutes were 40% less likely to develop high blood pressure compared to those consuming regular salt.
  • A cardiologist explains the findings.

It may be time to remove the salt shaker from your table. New research shows that using salt substitutes may effectively reduce your risk of high blood pressure and boost heart health.

The study published in the Journal of the American College of Cardiology looked at how replacing regular table salt with a potassium-enriched salt substitute (similar to this one) might impact blood pressure. It included over 600 Chinese adults who did not previously have high blood pressure. Researchers randomly assigned half of the participants to consume regular salt, and the other half to use a salt substitute.

Typical table salt is almost entirely sodium chloride. The salt substitute used in the study contained around one-third less sodium chloride than table salt. The salt substitute also contained 25% potassium chloride, which doesn’t raise blood pressure, the study noted.

After two years, researchers found that those using the salt substitute were 40% less likely to develop high blood pressure, or hypertension, compared to those using regular salt. People in the salt substitute group did not have an increased risk of low blood pressure episodes, or hypotension. These findings suggest that incorporating salt substitutes into your diet could potentially reduce the risk of developing hypertension and associated cardiovascular diseases without introducing additional health risks like low blood pressure.

The goal of a salt substitute is to replace the concerning component of salt (sodium) with another mineral (potassium) so that it still looks and tastes like salt but can offer a way to reduce risk and cut back on a person’s salt intake, explains Sadiya S. Khan, M.D., professor of cardiovascular epidemiology at Northwestern Medicine’s Feinberg School of Medicine and American Heart Association Go Red for Women volunteer. “This is very important because we know that salt is an important driver of poor heart health and risk for high blood pressure,” she notes.

Prior studies have demonstrated that eating less sodium lowers blood pressure. However, it is really hard to cut out sodium from a person’s diet, says Dr. Khan. And cutting it out completely could also be detrimental by causing low blood pressure. So, this has raised the question of whether we can replace sodium with an alternative salt or salt substitute.

Although there are clear benefits of using salt substitutes for many with high blood pressure, more research needs to be done about its effects on those with normal or healthy blood pressure as a prevention method for high blood pressure, says Dr. Khan. “There are also risks to using salt substitutes for people with conditions that impair potassium excretion, such as chronic kidney disease or heart failure, including arrhythmias and sudden cardiac death,” she notes.

It’s also important to note how different countries and different populations consume most of their sodium intake, adds Dr. Khan. “For example, in China, most of the sodium intake comes from adding salt in the process of cooking. In the U.S., nearly 70% of our sodium intake comes from consuming commercially processed food products or restaurant foods,” Dr. Khan notes. So this study is not necessarily indicative of the general population.

There may be other health benefits from a salt substitute that includes potassium, but the important thing in a healthy diet is balance, says Dr. Khan. “We need to ensure that all major macronutrients are being achieved in a good balance,” she advises. A heart-healthy balanced diet, like the Mediterranean diet, is important for overall heart health and one swap can’t eliminate the importance of the other parts of the diet as well as the overall caloric intake for a healthy diet, she explains.

Headshot of Madeleine Haase

Madeleine, Prevention’s assistant editor, has a history with health writing from her experience as an editorial assistant at WebMD, and from her personal research at university. She graduated from the University of Michigan with a degree in biopsychology, cognition, and neuroscience—and she helps strategize for success across Prevention’s social media platforms. 

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