Researchers in Nature Health calculated that replacing regular table salt with potassium-enriched substitutes across 193 countries could prevent nearly three million deaths and more than ten million new cases of cardiovascular disease and chronic kidney disease every year.
Health Burden Driven by Diet
Cardiovascular disease caused 19.2 million deaths in 2023. That is an increase of nearly 50 percent over the last 30 years.
The study was led by researchers at The George Institute for Global Health. They evaluated the worldwide impact of shifting national salt supplies to alternatives made by replacing a portion of sodium chloride with potassium chloride.
Consuming too much sodium is an established cause of high blood pressure.
Consuming not enough potassium is also an established cause. High blood pressure is a major risk factor for life threatening conditions like strokes, heart attacks and kidney disease, said Bruce Neal, Senior Professorial Fellow at The George Institute. Switching to potassium-enriched salt addresses both these dietary issues at the same time, with substantial health benefits.
Worldwide, roughly one in three adults aged 30 to 79 have high blood pressure. That is equivalent to approximately 1.4 billion people.
The World Health Organization (WHO) endorsed the use of potassium-enriched salt in 2025 to reduce blood pressure and lower cardiovascular disease risk.
Modeling Population-Wide Salt Replacement
The modeling examined several hypothetical scenarios for the world’s 4.6 billion adults. Transitioning only the regular table salt used in home cooking could prevent 1.85 million deaths annually. It could prevent 6.19 million cardiovascular and kidney disease cases annually. Replacing salt solely in processed foods accounts for a further 1.56 million deaths averted. It accounts for 5.46 million cases averted.
A targeted shift among 80 percent of diagnosed patients could prevent 590,000 deaths each year. It could prevent 1.72 million disease cases each year. For 80 percent of patients actively receiving treatment for high blood pressure, the model estimates 480,000 prevented deaths. It estimates 1.41 million averted cases.
Total annual health impacts vary substantially by nation under a full replacement scenario:
| Country | Annual Deaths Prevented | CVD and CKD Cases Prevented / Year | Total Fatal and Non-Fatal Events Prevented |
|---|---|---|---|
| China | 1,082,666 | 3,614,123 | 4,696,789 |
| India | 399,884 | 1,528,494 | 1,928,378 |
| USA | 104,787 | 491,905 | 596,692 |
| Mexico | 30,464 | 138,546 | 169,010 |
| Nigeria | 18,069 | 59,348 | 77,417 |
| United Kingdom | 12,951 | 59,988 | 72,939 |
| South Africa | 6,761 | 22,955 | 29,716 |
| Australia | 2,076 | 15,674 | 17,750 |
Food Industry Action Required to Substitute Salt
More than 70 percent of dietary salt intake comes from processed foods and restaurant meals in Europe and North America. It does not come from salt added at home.
To realise the maximum benefits from switching to potassium-enriched salt, we need to see the food industry in Europe and North America –
Neal said. 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,
he said.
Individuals with advanced kidney disease face potential risks of hyperkalaemia. Individuals taking medications that elevate blood potassium levels also face potential risks.
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 labelling, and clinical oversight,
Professor Vivek Jha, Nephrologist and Senior Professorial Fellow at The George Institute in India