Replacing some of the sodium in the world’s salt supply with potassium could avert nearly 3 million deaths and 10 million new cases of cardiovascular and kidney disease annually, according to a new global assessment from researchers at The George Institute for Global Health.
The analysis, published in Nature Health, modeled the potential effects of potassium-enriched salt across 193 countries. Its central premise is straightforward: conventional table salt is largely sodium chloride, while a salt substitute can replace part of that sodium chloride with potassium chloride. That change can address two dietary problems at once—excess sodium intake and insufficient potassium intake—both of which are associated with high blood pressure.
The results are projections rather than the outcome of a worldwide intervention. But they point to a potentially large public-health opportunity in a period when hypertension and cardiovascular disease remain major global burdens.
Why the balance of sodium and potassium matters
High blood pressure is a leading risk factor for stroke, heart attack and kidney disease. The researchers note that too much sodium and too little potassium are well-established contributors to elevated blood pressure. Potassium-enriched salt is designed to shift both sides of that balance while retaining the familiar role of salt in cooking and food preparation.
According to the source report, potassium-enriched salt looks, tastes and cooks like ordinary salt. Its formulation replaces a portion of sodium chloride with potassium chloride, rather than asking people to remove salt altogether. That may matter for practical adoption: a substitution that fits existing kitchens, food systems and habits could be easier to scale than a strategy that relies solely on consumers making sustained dietary changes.
The World Health Organization endorsed the use of potassium-enriched salt in 2025 as a way to reduce blood pressure and cardiovascular risk. The new analysis extends the discussion by estimating what broad uptake could mean on a country-by-country global basis.
A model of global potential
The researchers examined a range of hypothetical adoption scenarios. These ran from a complete replacement of regular salt with potassium-enriched salt to more limited use among people with diagnosed and treated hypertension. Even the more restricted scenarios produced substantial projected health gains, according to the report.
Under the broader global-switch scenario described by the researchers, nearly 3 million deaths and 10 million new cases of cardiovascular and kidney disease could be prevented every year. The study also found that a switch could avert as many as one in 10 cardiovascular deaths in most countries.
Those estimates arrive against a large baseline burden. The report says roughly one in three adults aged 30 to 79 worldwide—about 1.4 billion people—has hypertension. Cardiovascular disease caused 19.2 million deaths in 2023, according to figures cited in the source, and remains the leading cause of death and disability globally.
The projections should not be interpreted as a guarantee that every country would see the same result, or that switching salt alone would eliminate cardiovascular risk. Diet, access to medical care, tobacco use, physical activity and many other factors shape outcomes. The value of the analysis is in showing the scale of benefit that could be available if a widely used ingredient were reformulated at population level.
Potentially lower-cost prevention
Bruce Neal, a senior professorial fellow at The George Institute, said the health gains would be broad and argued that the approach could offer substantial benefits at lower cost than many drug-based treatments. The comparison reflects the unusual reach of salt as a public-health lever: it is used daily in homes and throughout commercial food production.
That reach also makes implementation more complicated than a simple household choice. A meaningful shift would involve manufacturers, retailers, regulators, health systems and food-service providers. Product standards, procurement policies, labeling and public education could all influence whether potassium-enriched products become common enough to affect population health.
Countries would also need to consider local dietary patterns and supply chains. In places where much sodium comes from packaged or prepared food rather than table salt added at home, changing retail table salt alone would have a limited effect. A broader strategy could require reformulating ingredients used by food producers as well.
Safety remains part of the equation
Potassium is not risk-free for everyone. The report notes concern about high potassium levels in people with kidney disease. For many people, dietary potassium is beneficial, but the body’s ability to manage potassium can be impaired in some forms of kidney disease, and certain medicines can also affect potassium handling.
That does not negate the population-level findings. It means implementation needs safeguards, especially for people known to be at higher risk. Clinical guidance, product labeling and targeted advice from health professionals would be important parts of any large-scale program.
The study’s contribution is therefore not a call for every individual to make an unsupervised dietary change. It is evidence that governments and health authorities can evaluate as they consider food policy, hypertension prevention and ways to reduce the global toll of cardiovascular and kidney disease.
From projection to policy
Salt substitution has the appeal of a relatively quiet intervention: it does not depend on a new hospital, a breakthrough drug or a complex device. Yet turning modeled benefits into real-world outcomes would require coordinated action and careful attention to safety.
The analysis makes the case that the opportunity is large enough to merit that work. If countries can safely replace a share of sodium in the salt people already use, the researchers’ estimates suggest the health effects could be measured not merely in lower blood pressure, but in millions fewer deaths and millions fewer new cases of serious disease each year.
This article is based on reporting by Medical Xpress. Read the original article.
Originally published on medicalxpress.com
