Can Switching to Potassium-Based Salt Substitutes Help Reduce Blood Pressure and Heart Disease Risk?

What Are Potassium-Enriched Salt Substitutes?
Ordinary salt is sodium chloride. Salt enriched with potassium displaces some amount of sodium chloride with potassium chloride, which will provide two fold benefits: intake of sodium reduces and potassium level increases. A high level of potassium has been correlated with a lowering of blood pressure significantly. Natural sources of potassium include beans, peas, nuts, vegetables like spinach and cabbage, and fruits such as bananas and papaya. ^[2]

WHO's Recommendations
The WHO limits the intake of sodium to less than 2 grams per day, or about 5 grams of salt. It promotes a decrease in the consumption of table salt and encourages partially replacing it with potassium-enriched salt. ^[1]

Evidence
Research indicates that using potassium-enriched salt substitutes can lower blood pressure by reducing sodium intake and increasing potassium consumption. A review of multiple studies found that these substitutes effectively decrease systolic and diastolic blood pressure. ^[3]

Considerations and Challenges
While the health benefits of potassium-enriched salt substitutes are undeniable, they may not be suitable for everyone. Patients with kidney disease, heart disease, liver disease, or diabetes should consult their healthcare providers before switching to potassium-enriched salt substitutes, as increased potassium intake can lead to hyperkalaemia, a condition characterised by elevated potassium levels in the blood. ^[4]

Further, a large part of the daily sodium intake comes from processed and restaurant foods where it is not easy to replace sodium with potassium because of such factors as taste preferences, preservation needs, and manufacturing processes. ^[1]

Conclusion
The use of potassium-enriched salt substitutes can be very practical in terms of managing blood pressure and also reducing the occurrence of cardiovascular diseases. However, one should consult a doctor prior to making these dietary changes to avoid exacerbating other health issues. A diet rich in potassium and less of processed foods complements this approach for better heart health.

References

1. World Health Organization. “Launch of the WHO Guideline on the Use of Lower-Sodium Salt Substitutes.” WHO, January 27, 2025. Accessed January 28, 2025. https://www.who.int/news-room/events/detail/2025/01/27/default-calendar/launch-of-the-who-guideline-on-the-use-of-lower-sodium-salt-substitutes.

2. Marengo, Katherine. “What Is Potassium Chloride and Why You May Want to Replace Salt with It.” Healthline, January 2025. Accessed January 28, 2025. https://www.healthline.com/health-news/what-is-potassium-chloride-and-why-you-may-want-to-replace-salt-with-it.

3. Neal, Bruce, Maoyi Tian, Mark Woodward, and Yangfeng Wu. “Salt Substitutes: A Healthy Alternative to the Real Thing?” Hypertension 74, no. 2 (2019): 253-261. https://doi.org/10.1161/HYPERTENSIONAHA.119.13241.

4. University Hospitals. “Salt Substitutes: A Healthy Alternative to the Real Thing.” UH Hospitals Health Blog, June 2023. Accessed January 28, 2025. https://www.uhhospitals.org/blog/articles/2023/06/salt-substitutes-a-healthy-alternative-to-the-real-thing.

(Input from various sources)

(Rehash/Pragati Sakhuja/MSM)