Hardly anyone uses this surprisingly simple blood pressure fix
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Hardly anyone uses this surprisingly simple blood pressure fix
A simple salt swap could lower blood pressure—yet almost no one is using it.
Date:
March 31, 2026
Source:
American Heart Association
Summary:
Salt substitutes offer a simple, low-cost way to reduce sodium intake and improve blood pressure, yet very few Americans actually use them—even among those who need them most. A large national analysis spanning nearly two decades found that usage remains surprisingly low and has not improved over time. Researchers say this gap represents a major missed opportunity for preventing heart disease and stroke.
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Salt substitutes can help lower blood pressure, but hardly anyone uses them. Experts say this overlooked habit could improve heart health for millions. Credit: Shutterstock
A surprisingly small number of people with high blood pressure are using salt substitutes, even though they offer an easy and effective way to cut sodium and improve heart health. That's the key finding from new preliminary research presented at the American Heart Association's Hypertension Scientific Sessions 2025, a major conference focused on the latest advances in high blood pressure research and its links to heart, kidney, and metabolic diseases.
High blood pressure develops when the force of blood pushing through the arteries stays consistently elevated. Over time, this can damage blood vessels and significantly raise the risk of heart attacks, strokes, and other serious conditions.
Between 2017 and 2020, about 122.4 million (46.7%) adults in the United States were living with high blood pressure, contributing to more than 130,000 deaths. Diet plays a major role. Consuming too much sodium and not enough potassium are key contributors to elevated blood pressure.
Salt Substitutes: A Low-Cost but Underused Option
"Overall, less than 6% of all U.S. adults use salt substitutes, even though they are inexpensive and can be an effective strategy to help people control blood pressure, especially people with difficult-to-treat high blood pressure," said lead study author Yinying Wei, M.C.N., R.D.N., L.D., and Ph.D. candidate in the departments of applied clinical research and hypertension section, cardiology division, at UT Southwestern Medical Center in Dallas.
"Health care professionals can raise awareness about the safe use of salt substitutes by having conversations with their patients who have persistent or hard-to-manage high blood pressure."
Salt substitutes work by replacing some or all of the sodium in regular salt with potassium. While potassium salt has a similar flavor, it can develop a slightly bitter taste when heated.
Although many foods naturally contain sodium, most people consume the majority of it through processed foods, packaged items, and restaurant meals. The American Heart Association recommends limiting sodium intake to no more than 2,300 mg per day, with an ideal target of less than 1,500 mg for most adults, especially those with high blood pressure. Even reducing intake by 1,000 mg per day can lead to meaningful improvements in blood pressure and overall heart health.
Two Decades of Data Reveal a Persistent Gap
This study is the first to track long-term trends in salt substitute use across a nationally representative group of U.S. adults. Researchers analyzed data from the National Health and Nutrition Examination Survey (NHANES) collected between 2003 and 2020, focusing on products that replace traditional salt with potassium-enriched or alternative salts.
Who Can Safely Use Salt Substitutes?
The research paid special attention to people with high blood pressure and also examined a subgroup of adults considered safe candidates for salt substitutes. This included individuals with normal kidney function and those not taking medications or supplements that influence potassium levels.
Some salt substitutes contain potassium, which can build up to dangerous levels in people with kidney disease or those taking certain medications or supplements. High potassium levels can lead to abnormal heart rhythms. Because of this, people with high blood pressure should consult a health care professional before making the switch.
Key Findings: Usage Remains Surprisingly Low
The analysis showed that salt substitute use has remained consistently low across the U.S. population:
- Use peaked at 5.4% in 2013-2014 but dropped to 2.5% by 2017-March 2020. Data collection for 2020 ended early due to the pandemic.
- Among people eligible to safely use salt substitutes, only 2.3% to 5.1% reported using them.
- Usage was highest among individuals with high blood pressure controlled by medication (3.6%-10.5%), followed by those whose blood pressure remained uncontrolled despite treatment (3.7%-7.4%).
- Fewer than 5.6% of people with untreated high blood pressure or normal blood pressure used salt substitutes.