Replacing regular table salt with a potassium-enriched alternative worldwide could prevent nearly three million deaths and avoid over ten million new cases of cardiovascular and chronic kidney diseases annually, according to a comparative risk assessment modelling study published in nature.com.
Potassium Salt Blends Lower Blood Pressure and Reduce Global Disease Deaths
- The Core Mechanism: Swapping standard sodium chloride for a potassium-enriched salt blend lowers blood pressure by simultaneously reducing sodium intake and increasing potassium intake.
- The Scale of Impact: Researchers estimate this dietary shift could avert roughly 14.6% of global deaths linked to cardiovascular and kidney diseases each year.
- The Safety Caveat: While highly effective for the general population, individuals with advanced chronic kidney disease must exercise caution due to hyperkalaemia risks.
Global Projections for Salt Substitution Models
Led by researchers from institutions including The George Institute for Global Health and Johns Hopkins Bloomberg School of Public Health, and published via medrxiv.org, the study evaluated five distinct intervention scenarios across 193 countries and territories. The analysis utilized population data from the 2021 Global Burden of Disease (GBD) study to project how altering dietary sodium and potassium ratios would shift systolic blood pressure (SBP) distribution globally.
Under the broadest scenario modeling worldwide replacement of all salt—covering both discretionary salt used in home cooking and non-discretionary salt hidden in processed and restaurant foods—the model projected 2.96 (95% uncertainty interval 2.81-3.12) million averted deaths. Specifically, medrxiv.org reported that this total encompasses 10.17 (9.59-10.70) million new cases of disease and 69.43 (65.61-72.92) million disability-adjusted life years (DALYs) each year. These figures account for roughly 14.6%, 13.1%, and 16.5% of the total global disease burden attributable to cardiovascular disease (CVD) and chronic kidney disease (CKD).
When breaking down sources of dietary sodium, the study found that replacing all discretionary salt alone yielded 1.85, 1.74-1.97 million deaths. In contrast, replacing non-discretionary salt across processed foods accounted for 1.56, 1.46-1.67 million deaths. This distinction highlights the heavy public health burden tied to domestic seasoning habits versus commercial food manufacturing.
Balancing Blood Pressure Benefits Against Renal Risks
To account for this, the model factored in the prevalence of CKD stages G3 through G5, where the estimated glomerular filtration rate (eGFR) drops below 60 milliliters per minute per 1.73 square meters.
According to baseline data embedded in the model, the prevalence of CKD stages G3–5 among US adults with hypertension sat at 8.9% in 2015 to 2018. Despite the theoretical hazard of hyperkalaemia-related mortality in this demographic, the net global balance remained overwhelmingly positive. Even when factoring in potential potassium toxicity risks, the complete replacement of all salt would prevent 0.75 (0.71-0.80) million death in individuals with CKD Stage G3-G5.
Potassium-Enriched Salt Substitutes Are Not Universally Safe
Potassium-enriched salt substitutes are not universally safe.
References
- Huang, L., et al. (2026). Global health outcomes from replacing dietary sodium chloride with potassium-enriched salt: a modelling study. Nature / medRxiv. DOI: 10.64898/2026.04.06.26350270.
- Global Burden of Disease (GBD) Study. (2021). Country-, age-, and sex-specific estimates for cardiovascular disease and chronic kidney disease burden.
- Non-Communicable Disease Risk Factor Collaboration. (2019). National-level hypertension prevalence and treatment proportions.
