Introduction
A recent study presented at the American Heart Association’s Hypertension Scientific Sessions 2025 revealed that a limited number of individuals with high blood pressure are utilizing salt substitutes, despite their effectiveness in reducing sodium intake and aiding in blood pressure management. This meeting represents a vital scientific forum dedicated to the latest advancements in hypertension-related research and its implications for cardiac, kidney, and overall health.
Understanding High Blood Pressure
High blood pressure, or hypertension, is characterized by consistently elevated force of blood against artery walls. This condition can precipitate severe health complications, including heart attacks and strokes. Data from 2017 to 2020 indicate that approximately 122.4 million adults in the U.S., accounting for 46.7%, were living with high blood pressure, contributing to over 130,000 fatalities. Dietary factors, particularly excessive sodium and inadequate potassium intake, are recognized risk factors.
Study Insights on Salt Substitute Usage
According to lead author Yinying Wei, M.C.N., R.D.N., L.D., a doctoral candidate at UT Southwestern Medical Center, “Only about 6% of U.S. adults incorporate salt substitutes into their diets, despite their affordability and effectiveness in managing blood pressure, especially for those with treatment-resistant hypertension.” Wei emphasizes the role of healthcare professionals in promoting awareness regarding the safe usage of salt substitutes during consultations with patients facing persistent high blood pressure challenges.
What Are Salt Substitutes?
Salt substitutes are products designed to replace some or all sodium content with potassium. While potassium-enhanced salt generally mirrors the taste of regular salt, it may exhibit a bitter aftertaste when heated. Notably, many foods naturally contain sodium; however, a significant proportion of dietary sodium is derived from processed foods and restaurant meals. The American Heart Association advises limiting sodium intake to no more than 2,300 mg per day, with an optimal target of less than 1,500 mg for most adults, particularly those with hypertension. Reducing sodium intake by 1,000 mg daily can notably enhance blood pressure and cardiovascular health.
Research Methodology
This study marks the first comprehensive analysis of long-term trends in salt substitute use among a nationally representative sample of U.S. adults. Data derived from the National Health and Nutrition Examination Survey (NHANES) spanning 2003 to 2020 was evaluated, focusing specifically on individuals with high blood pressure and those eligible for salt substitutes based on kidney function and medication usage.
Findings on Salt Substitute Use
The investigation yielded several significant findings:
- Salt substitute usage among U.S. adults peaked at 5.4% in the 2013-2014 period before declining to 2.5% by March 2020, prior to the pandemic.
- Among those eligible to use these substitutes, usage ranged from 2.3% to 5.1%.
- Usage was highest among those with controlled high blood pressure using medication (3.6%-10.5%), followed closely by those with untreated but persistent high blood pressure (3.7%-7.4%).
- Salt substitute use remained below 5.6% in individuals with untreated hypertension and in those with normal blood pressure.
- Frequent restaurant-goers (three or more times a week) showed reduced use of salt substitutes compared to others; however, this finding was not statistically significant after adjusting for various demographic factors.
Analysis and Implications
According to Wei, “The consistent low prevalence of salt substitute use over the past two decades—particularly among individuals with high blood pressure—is concerning. Many still opt for regular salt.” Dr. Amit Khera, a volunteer expert with the American Heart Association, highlighted the missed opportunity for blood pressure improvement through the adoption of salt substitutes, advocating for increased dialogue between patients and healthcare providers surrounding this topic.
Study Limitations
The findings are subject to several limitations. Primarily, the self-reported nature of salt substitute usage may lead to potential underreporting or inaccuracies. Additionally, the study grouped all classifications of salt substitutes together, making it challenging to distinguish between potassium-enriched salts and other variants. Furthermore, the survey did not quantify the amount of salt substitute consumed by participants.
Future Research Directions
Wei suggests that future inquiries should focus on identifying the barriers to salt substitute utilization, such as taste preferences, cost, and awareness levels among both patients and healthcare providers. Such insights could inform targeted interventions to enhance salt substitute adoption.
Key Health Takeaway
Despite their proven role in managing hypertension, salt substitutes are underutilized among those affected. Increased awareness and discussions between healthcare providers and patients may significantly contribute to better blood pressure control.
