A global study spanning 193 countries suggests that a simple change to everyday salt could prevent millions of deaths and cases of cardiovascular and kidney disease each year.
Replacing ordinary salt with a potassium-enriched alternative could prevent nearly three million deaths worldwide each year, according to a new study covering 193 countries. Researchers estimate that a global switch could also prevent more than ten million new cases of cardiovascular and kidney disease annually, offering a potentially powerful way to reduce the health burden of high blood pressure.
The analysis, led by The George Institute for Global Health, examined how different levels of salt replacement might affect the world’s 4.6 billion adults. The findings suggest that even limited changes, particularly among people already diagnosed with high blood pressure, could produce substantial health gains.
How a Simple Salt Substitute Could Protect Health
Potassium-enriched salt replaces part of the sodium chloride in regular table salt with potassium chloride. It looks, tastes, and performs much like conventional salt in cooking but contains less sodium and provides additional potassium, two changes that can help lower blood pressure.
“Consuming too much sodium and not enough potassium are well established causes of high blood pressure, a major risk factor for life-threatening conditions like strokes, heart attacks and kidney disease. Switching to potassium-enriched salt addresses both these dietary issues at the same time, with substantial health benefits,” said Bruce Neal, Senior Professorial Fellow at The George Institute.
High blood pressure (hypertension) affects approximately 1.4 billion adults aged 30 to 79 worldwide, or roughly one in three people in that age group. Cardiovascular disease (CVD) caused 19.2 million deaths in 2023, nearly 50 percent more than three decades earlier. In 2025, the World Health Organization (WHO) endorsed potassium-enriched salt as a way to reduce blood pressure and cardiovascular risk.
Major Health Benefits Without a Complete Switch
The researchers modeled several scenarios, including replacing all salt consumed at home, in restaurants, and in processed foods. Switching only household table salt could prevent approximately 1.85 million deaths and 6.19 million new cases of cardiovascular and chronic kidney disease annually. Replacing salt exclusively in processed and restaurant foods could prevent another estimated 1.56 million deaths and 5.46 million new disease cases each year under that separate scenario.
More targeted approaches also showed considerable potential. If 80 percent of people with diagnosed hypertension switched their household salt, the model projected approximately 590,000 fewer deaths annually. Among those receiving treatment for hypertension, a comparable level of adoption could prevent about 480,000 deaths each year.
“While a global shift from regular salt to a potassium-enriched substitute is aspirational, this is a starting point to get countries thinking about the opportunity, with much greater potential and at much lower cost than many drug-based treatments,” Neal said.
Which Countries Could Benefit Most?
The projected benefits varied considerably between countries. Under a complete replacement scenario, China could prevent approximately 1.08 million deaths and 3.61 million new cardiovascular and kidney disease cases annually. India could avert nearly 400,000 deaths and 1.53 million new cases, while the United States could prevent approximately 105,000 deaths and 492,000 new cases.
Achieving these reductions would require strategies tailored to how people consume salt. In many countries, household cooking accounts for a substantial share of sodium intake. In Europe and North America, however, processed and restaurant foods contribute more than 70 percent, making cooperation from food manufacturers and restaurants essential.
“To realize the maximum benefits from switching to potassium-enriched salt, we need to see the food industry in Europe and North America, where over 70% of salt intake comes from processed and restaurant foods, get on board. This would also require investigating ways to scale up the production of potassium chloride to meet demand,” Neal said.
What About the Risks of Extra Potassium?
Although potassium-enriched salt can help lower blood pressure, it may pose risks for people whose kidneys cannot effectively remove excess potassium from the bloodstream. This can lead to hyperkalemia, a potentially dangerous condition that can disrupt the heart’s electrical activity. People with advanced kidney disease and those taking certain medications that increase blood potassium levels require particular caution.
The study’s modeling suggested that the overall health benefits could outweigh the risks even among people with advanced kidney disease. However, that population-level finding does not mean potassium-enriched salt is safe for every individual.
“People with serious kidney disease and those taking medications that significantly raise blood potassium levels need to take precautions. Risks for this group can be managed effectively through patient education, product labeling, and clinical oversight,” said Professor Vivek Jha, a nephrologist and Senior Professorial Fellow at The George Institute in India.
Reference: “Global health outcomes from replacing dietary sodium chloride with potassium-enriched salt” by Liping Huang, Xiaoyue Xu, Kunihiro Matsushita, Tammy M. Brady, Lawrence J. Appel, Ewout J. Hoorn, Aletta E. Schutte, Jason H. Y. Wu, Maoyi Tian, Leopold N. Aminde, Kathy Trieu, Bruce Neal and Matti Marklund, 4 November 2026, Nature Health.
DOI: 10.1038/s44360-026-00216-9
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