Salt substitutes could be a simple and low-cost way to help people lower their blood pressure, but very few people in the United States are using them.
This finding comes from new research presented at the American Heart Association’s Hypertension Scientific Sessions 2025, a major event where experts share the latest research on blood pressure and related health issues.
High blood pressure, also called hypertension, happens when the force of blood moving through the blood vessels is too strong. Over time, it can lead to serious problems like heart attacks and strokes. According to data from 2017 to 2020, nearly 122 million adults in the U.S. had high blood pressure, and it contributed to more than 130,000 deaths.
Eating too much sodium and not enough potassium are two key factors that raise blood pressure. Salt substitutes are one way to address this. These products replace some or all of the sodium in table salt with potassium.
Potassium salt tastes similar to regular salt, though it can have a slightly bitter aftertaste when heated. Still, using salt substitutes is a recommended way to reduce sodium intake and lower blood pressure.
Despite the potential benefits, the study found that less than 6% of U.S. adults used salt substitutes. Usage was slightly higher in people whose blood pressure was being controlled with medication, and in those whose high blood pressure was still not under control despite treatment. However, the rates remained very low overall.
The study was led by Yinying Wei, a PhD candidate at UT Southwestern Medical Center in Dallas. Wei noted that health care providers could help more by talking with patients about salt substitutes and how they can be used safely.
Salt substitutes can be especially helpful for people with hard-to-manage high blood pressure. But not everyone should use them. People with kidney problems or those taking certain medications or potassium supplements may be at risk for too much potassium in the blood, which can lead to dangerous heart rhythms.
That’s why it’s important for people to talk to their doctors before switching from regular salt to a substitute.
The researchers used data from the National Health and Nutrition Examination Survey, covering the years from 2003 to 2020. They looked at a total of 37,080 adults and focused on how often people used salt substitutes.
They also studied how eating at restaurants might affect salt substitute use. People who ate out more than three times a week were less likely to use salt substitutes, but this difference disappeared after adjusting for other factors like age, race, and income.
The study showed that even among people eligible to use salt substitutes safely—those with healthy kidneys and not taking potassium-altering drugs—only 2.3% to 5.1% were using them. This suggests a large missed opportunity to help people control their blood pressure through diet.
Experts say more needs to be done to raise awareness about the benefits of salt substitutes. Simple changes in the kitchen could lead to big improvements in heart health. Future studies should also look at why people don’t use salt substitutes more often, and whether issues like taste, cost, or lack of knowledge are getting in the way.
If you care about blood pressure, please read studies about unhealthy habits that could increase high blood pressure risk, and people with severe high blood pressure should reduce coffee intake.
For more information about blood pressure, please see recent studies that early time-restricted eating could help improve blood pressure, and results showing plant-based foods could benefit people with high blood pressure.
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