High blood pressure is often called the “silent killer” because it usually has no clear symptoms.
Many people do not know they have it until it leads to serious health problems such as a heart attack, stroke, heart failure, or kidney disease.
In the United States, nearly half of all adults have high blood pressure, making it one of the country’s biggest health challenges.
Doctors have long known that eating too much sodium raises blood pressure. Most sodium comes from processed foods, packaged snacks, fast food, and restaurant meals rather than the salt shaker at home. At the same time, many people do not get enough potassium, an important mineral that helps balance the effects of sodium and supports healthy blood pressure.
One simple way to reduce sodium is to use a salt substitute instead of regular table salt. These products replace some or most of the sodium with potassium. They taste very similar to ordinary salt, although some people notice a slight bitter taste when they are used in cooking.
Salt substitutes are inexpensive and easy to find in many supermarkets. Research has shown that they can help lower blood pressure in many people, making them a practical option for improving heart health. Even so, a new study suggests that very few Americans are taking advantage of them.
The research was presented at the American Heart Association’s Hypertension Scientific Sessions 2025. Scientists found that fewer than 6% of U.S. adults use salt substitutes. Their use reached its highest level at 5.4% in 2013–2014 but fell to only 2.5% by 2020.
The numbers were also surprisingly low among people with high blood pressure. Even adults whose blood pressure remained difficult to control with medication rarely reported using salt substitutes. Among people who could safely use these products, the percentage was still only between about 2% and 5%.
The researchers analyzed information from more than 37,000 adults who took part in the National Health and Nutrition Examination Survey between 2003 and 2020.
They compared people with normal blood pressure, people with high blood pressure, and those taking blood pressure medicines. They also looked at eating habits, including how often people ate at restaurants.
The study found that people who ate out several times each week were slightly less likely to use salt substitutes, although this difference became smaller after other factors such as age, education, race, and health insurance were considered. The researchers also noted that the study relied on people reporting their own habits, which is one limitation.
Salt substitutes are not suitable for everyone. Because they contain potassium, they can be unsafe for people with kidney disease or those taking certain medicines or supplements that increase potassium levels. Too much potassium can cause dangerous changes in heart rhythm, so anyone considering a switch should first speak with a healthcare professional.
For most adults with healthy kidneys, however, salt substitutes are considered a safe way to reduce sodium intake.
The researchers believe the low level of use represents a missed opportunity to improve public health. Raising awareness about this simple change could help more people manage high blood pressure, lower their risk of heart disease and stroke, and enjoy healthier lives.
If you care about high blood pressure, please read studies about unhealthy habits that may increase high blood pressure risk, and drinking green tea could help lower blood pressure.
For more information about high blood pressure, please see recent studies about what to eat or to avoid for high blood pressure, and 12 foods that lower blood pressure.
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