What is the effect of a reduced-sodium added-potassium salt substitute diet?

    Last Updated: October 13, 2024

    A reduced-sodium added-potassium salt substitute is sometimes used to supplement a sodium-restricted (reduced salt) diet to help treat hypertension. Such salt substitutes typically contain a reduced amount of sodium chloride and an added amount of potassium chloride, and randomized controlled trials show that they can effectively reduce blood pressure.[1][2][3][4][5] However, this does not mean that more is better — some evidence shows that supplementation with potassium salts in high doses might increase blood pressure.[6]

    Because high blood pressure increases the risk of cardiovascular disease and stroke-related mortality, it is possible that the blood-pressure-lowering effect of a reduced-sodium added-potassium salt substitute could reduce mortality risk. Some current evidence supports this hypothesis,[1][2][7] but due to the dearth of studies and the large between-study variability, further long-term high-quality observational studies and randomized controlled trials are needed to make firm conclusions.

    References

    1. ^Bruce Neal, Yangfeng Wu, Xiangxian Feng, Ruijuan Zhang, Yuhong Zhang, Jingpu Shi, Jianxin Zhang, Maoyi Tian, Liping Huang, Zhifang Li, Yan Yu, Yi Zhao, Bo Zhou, Jixin Sun, Yishu Liu, Xuejun Yin, Zhixin Hao, Jie Yu, Ka-Chun Li, Xinyi Zhang, Peifen Duan, Faxuan Wang, Bing Ma, Weiwei Shi, Gian Luca Di Tanna, Sandrine Stepien, Sana Shan, Sallie-Anne Pearson, Nicole Li, Lijing L Yan, Darwin Labarthe, Paul ElliottEffect of Salt Substitution on Cardiovascular Events and DeathN Engl J Med.(2021 Sep 16)
    2. ^Tsai YC, Tsao YP, Huang CJ, Tai YH, Su YC, Chiang CE, Sung SH, Chen CH, Cheng HMEffectiveness of salt substitute on cardiovascular outcomes: A systematic review and meta-analysis.J Clin Hypertens (Greenwich).(2022-Sep)
    3. ^Yu J, Thout SR, Li Q, Tian M, Marklund M, Arnott C, Huffman MD, Praveen D, Johnson C, Huang L, Pettigrew S, Neal B, Wu JHYEffects of a reduced-sodium added-potassium salt substitute on blood pressure in rural Indian hypertensive patients: a randomized, double-blind, controlled trial.Am J Clin Nutr.(2021 Jul 1)
    4. ^Zhou B, Webster J, Fu LY, Wang HL, Wu XM, Wang WL, Shi JPIntake of low sodium salt substitute for 3years attenuates the increase in blood pressure in a rural population of North China - A randomized controlled trial.Int J Cardiol.(2016 Jul 15)
    5. ^Zhao X, Yin X, Li X, Yan LL, Lam CT, Li S, He F, Xie W, Sang B, Luobu G, Ke L, Wu YUsing a low-sodium, high-potassium salt substitute to reduce blood pressure among Tibetans with high blood pressure: a patient-blinded randomized controlled trial.PLoS One.(2014)
    6. ^Filippini T, Naska A, Kasdagli MI, Torres D, Lopes C, Carvalho C, Moreira P, Malavolti M, Orsini N, Whelton PK, Vinceti MPotassium Intake and Blood Pressure: A Dose-Response Meta-Analysis of Randomized Controlled Trials.J Am Heart Assoc.(2020-06-16)
    7. ^Hao Sun, Bing Ma, Xiaomei Wu, Hailong Wang, Bo ZhouLong-Term Effect of Salt Substitute on All-Cause and Cardiovascular Disease Mortality: An Exploratory Follow-Up of a Randomized Controlled TrialFront Cardiovasc Med.(2021 May 17)