Salt Substitute Use Remains Low Among Americans With High Blood Pressure

Few group pinch precocious humor unit were utilizing brackish substitutes, moreover though they are a elemental and effective measurement to little sodium intake and negociate humor pressure, according to preliminary investigation presented astatine nan American Heart Association's Hypertension Scientific Sessions 2025. The gathering is successful Baltimore, September 4-7, 2025, and is nan premier technological speech focused connected caller advances successful basal and objective investigation connected precocious humor unit and its narration to cardiac and kidney disease, stroke, obesity and genetics.

High humor pressure occurs erstwhile nan unit of humor flowing done nan humor vessels is consistently excessively high. High humor unit tin lead to different superior events specified as heart attack and stroke. Using information from 2017 to 2020, 122.4 cardinal (46.7%) adults successful nan U.S. had precocious humor unit and it contributed to much than 130,000 deaths. Too overmuch sodium and excessively small potassium successful nan fare are consequence factors for precocious humor pressure.

Overall, little than 6% of each U.S. adults usage brackish substitutes, moreover though they are inexpensive and tin beryllium an effective strategy to thief group power humor pressure, particularly group pinch difficult-to-treat precocious humor pressure. Health attraction professionals tin raise consciousness astir nan safe usage of brackish substitutes by having conversations pinch their patients who person persistent aliases hard-to-manage precocious humor pressure."

Yinying Wei, M.C.N., R.D.N., L.D., lead study writer and Ph.D. campaigner successful nan departments of applied objective investigation and hypertension section, cardiology division, astatine UT Southwestern Medical Center, Dallas

Salt substitutes are products that switch immoderate aliases each of nan sodium pinch potassium. Potassium brackish tastes akin to regular salt, isolated from erstwhile heated it tin person a bitter aftertaste. Many foods incorporate immoderate sodium successful their earthy state, however, nan largest magnitude of sodium comes from processed and packaged foods and meals prepared astatine restaurants. The American Heart Association recommends consuming nary much than 2,300 mg of sodium a day, pinch an perfect limit of little than 1,500 mg per time for astir adults, particularly for those pinch precocious humor pressure. For astir people, cutting backmost by 1,000 mg a time tin amended humor unit and bosom health.

This study is nan first to analyse semipermanent trends successful brackish substitute usage among a nationally typical sample of U.S. adults. Using information from nan National Health and Nutrition Examination Survey (NHANES) from 2003 to 2020, researchers analyzed nan usage of products that switch brackish pinch potassium-enriched aliases different replacement salts.

The investigation focused connected group pinch precocious humor pressure, and an further study was conducted among adults eligible to usage brackish substitutes, including group pinch normal kidney usability and those not taking medications aliases supplements that impact humor potassium levels. Some brackish substitutes incorporate potassium, and they tin raise humor potassium to vulnerable levels successful group pinch kidney illness aliases those taking definite medications aliases potassium supplements. Excessive potassium tin lead to irregular bosom rhythms. People pinch precocious humor unit who are reasoning astir switching from regular brackish to a brackish substitute should first consult pinch a wellness attraction professional.

The study found:

• Overall, brackish substitute usage among each U.S. adults remained low, peaking astatine 5.4% successful 2013–2014 earlier falling to 2.5% by 2017–March 2020. Data postulation for 2020 stopped earlier March because of nan pandemic.
• Among adults eligible to usage brackish substitutes, only 2.3% to 5.1% did so.
• Usage was highest successful group pinch precocious humor unit whose BP was controlled pinch medications (3.6%–10.5%), followed by those pinch precocious humor unit whose BP was not controlled contempt medications (3.7%–7.4%).
• Salt substitute usage remained consistently little than 5.6% among group pinch untreated precocious humor unit and for group pinch normal humor pressure.
• Adults who ate astatine restaurants 3 aliases much times a week appeared little apt to usage brackish substitutes compared to those who ate retired little often, but this quality was nary longer statistically important aft accounting for age, race/ethnicity, acquisition level and security status.

"Salt substitute usage remained uncommon complete nan past 2 decades including among group pinch precocious humor pressure," Wei said. "Even among individuals pinch treated and poorly managed aliases untreated precocious humor pressure, astir continued to usage regular salt."

"This study highlights an important and easy missed opportunity to amended humor unit successful nan U.S.-the usage of brackish substitutes," said Amit Khera, M.D., M.Sc., FAHA, an American Heart Association unpaid expert. "The truth that usage of brackish substitutes remains truthful debased and has not improved successful 2 decades is eye-opening and reminds patients and wellness attraction professionals to talk nan usage of these substitutes, peculiarly successful visits focused connected precocious humor pressure." Khera, who was not progressive successful this study, is simply a professor of medicine, objective main of cardiology and head of preventive cardiology astatine UT Southwestern Medical Center successful Dallas.

The study has respective limitations. First, accusation astir brackish substitute usage was self-reported, truthful location whitethorn person been underreporting aliases misclassification. In addition, each types of brackish substitutes were included successful nan analysis, therefore, nan study could not specifically abstracted potassium-enriched brackish from different types of brackish substitutes. Finally, nan study information did not seizure really overmuch brackish substitute nan participants used.

"Future investigation should research why brackish substitute-use remains debased by investigating imaginable barriers, specified arsenic sensation acceptance, costs and constricted consciousness among some patients and clinicians," said Wei. "These insights whitethorn thief guideline much targeted interventions."

Study details, inheritance and design:  

• The study included 37,080 adults, ages 18 and older (37.9% were aged 18–39, 36.9% were aged 40–59 years, and 25.2% were aged 60 and older). 50.6% of participants were women, 10.7% of participants self-reported their title arsenic non-Hispanic Black, and 89.3% self-reported they were from different group and taste groups.
• Participants were categorized into 4 subgroups based connected beingness aliases absence of precocious humor unit (≥130/80 mm Hg) and whether they were utilizing humor unit lowering medication: 1) precocious humor unit that was treated and controlled; 2) precocious humor unit that was treated and not controlled; 3) untreated precocious humor pressure; and 4) those pinch normal humor pressure.
• Salt types were classified arsenic mean brackish (iodized salt, oversea salt, kosher salt), brackish substitute (potassium-enriched aliases different brackish substitute) and nary brackish use.
• An further study was conducted connected a subgroup of individuals eligible to usage brackish substitutes-those pinch patient kidney usability (estimated glomerular filtration complaint ≥ 60) and not taking medications aliases supplements that impact humor potassium levels. 
• The wave of eating astatine restaurants to measure its power connected brackish substitute usage was besides evaluated.
• All analyses incorporated NHANES sampling weights and analyzable study design.