Healthier salt could prevent millions of deaths from heart disease and stroke, study finds

Switching to potassium-enriched salt could prevent almost three million deaths and 10 million cases of cardiovascular and kidney disease worldwide every year, researchers say. Replacing table salt with a potassium-enriched alternative could prevent almost three million deaths annually worldwide, according to new research highlighting a potentially low-cost way to tackle high blood pressure and cardiovascular disease. The study, led by researchers at The George Institute for Global Health in Australia, assessed the potential health benefits of switching to potassium-enriched salt across 193 countries. It estimated that a global transition could prevent 2.96 million deaths and 10.17 million new cases of cardiovascular disease and chronic kidney disease every year. “Consuming too much sodium and not enough potassium are well established causes of high blood pressure - a major risk factor for life threatening conditions like strokes, heart attacks and kidney disease,” Bruce Neal, senior professorial fellow at The George Institute, said in a press release. The alternative, which can be found in some stores and online, works by replacing some of the sodium chloride in conventional salt with potassium chloride. It looks, tastes and cooks like ordinary table salt, but addresses two dietary factors associated with high blood pressure: excessive sodium consumption and insufficient potassium intake. "Switching to potassium-enriched salt addresses both these dietary issues at the same time, with substantial health benefits," Neal said. High blood pressure is a major risk factor for strokes, heart attacks and kidney disease. Around one in three adults aged 30 to 79 worldwide — approximately 1.4 billion people — have hypertension, according to the World Health Organization. Cardiovascular disease remains the world's leading cause of death and disability, accounting for 19.2 million deaths in 2023. Even partial transition brings health gains The researchers examined several scenarios, including replacing salt used in household cooking, switching salt used in processed and restaurant foods and targeting people already diagnosed with or receiving treatment for high blood pressure. Even a partial transition could deliver substantial gains. Replacing household salt alone could prevent an estimated 1.85 million deaths and 6.19 million cases of cardiovascular and kidney disease annually. Switching salt used in processed and restaurant foods could prevent a further 1.56 million deaths and 5.46 million cases. In Europe and North America, more than 70% of dietary salt intake comes from processed foods and restaurant meals, not salt added at home, according to Neal. "To realise the maximum benefits from switching to potassium-enriched salt, we need to see the food industry in Europe and North America ... get on board," Neal said. The potential benefits are particularly significant in countries with large populations and high levels of cardiovascular disease. A complete switch could prevent an estimated 1.08 million deaths annually in China, followed by India with almost 400,000. In the United Kingdom, the researchers estimate that replacing all conventional salt could prevent nearly 13,000 deaths and around 60,000 cases of cardiovascular and kidney disease each year. However, wider adoption is not without potential risks. People with advanced kidney disease, as well as those taking certain medications that increase potassium levels, may be vulnerable to hyperkalaemia — an excessive concentration of potassium in the blood. "Risks for this group can be managed effectively through patient education, product labelling, and clinical oversight," said Vivek Jha, a nephrologist and senior professorial fellow at The George Institute in India. The World Health Organization endorsed the use of potassium-enriched salt in 2025 as a way to reduce blood pressure and cardiovascular disease risk. He acknowledged that a worldwide transition would be ambitious, not least because of the need to expand production of potassium chloride to meet demand. "While a global shift from regular salt to a potassium-enriched substitute is aspirational, this is a starting point to get countries thinking about the opportunity — with much greater potential and at much lower cost than many drug-based treatments," he said.