A surprisingly small variety of individuals with hypertension are utilizing salt substitutes, though they provide a straightforward and efficient option to lower sodium and enhance coronary heart well being. That is the important thing discovering from new preliminary analysis offered on the American Coronary heart Affiliation’s Hypertension Scientific Classes 2025, a serious convention centered on the newest advances in hypertension analysis and its hyperlinks to coronary heart, kidney, and metabolic ailments.
Hypertension develops when the power of blood pushing by the arteries stays constantly elevated. Over time, this may injury blood vessels and considerably elevate the chance of coronary heart assaults, strokes, and different severe situations.
Between 2017 and 2020, about 122.4 million (46.7%) adults in the US had been dwelling with hypertension, contributing to greater than 130,000 deaths. Eating regimen performs a serious position. Consuming an excessive amount of sodium and never sufficient potassium are key contributors to elevated blood strain.
Salt Substitutes: A Low-Value however Underused Choice
“General, lower than 6% of all U.S. adults use salt substitutes, though they’re cheap and might be an efficient technique to assist individuals management blood strain, particularly individuals with difficult-to-treat hypertension,” stated lead examine writer Yinying Wei, M.C.N., R.D.N., L.D., and Ph.D. candidate within the departments of utilized scientific analysis and hypertension part, cardiology division, at UT Southwestern Medical Heart in Dallas.
“Well being care professionals can elevate consciousness in regards to the secure use of salt substitutes by having conversations with their sufferers who’ve persistent or hard-to-manage hypertension.”
Salt substitutes work by changing some or the entire sodium in common salt with potassium. Whereas potassium salt has the same taste, it will possibly develop a barely bitter style when heated.
Though many meals naturally include sodium, most individuals eat nearly all of it by processed meals, packaged objects, and restaurant meals. The American Coronary heart Affiliation recommends limiting sodium consumption to not more than 2,300 mg per day, with a super goal of lower than 1,500 mg for many adults, particularly these with hypertension. Even lowering consumption by 1,000 mg per day can result in significant enhancements in blood strain and total coronary heart well being.
Two A long time of Knowledge Reveal a Persistent Hole
This examine is the primary to trace long-term developments in salt substitute use throughout a nationally consultant group of U.S. adults. Researchers analyzed knowledge from the Nationwide Well being and Vitamin Examination Survey (NHANES) collected between 2003 and 2020, specializing in merchandise that change conventional salt with potassium-enriched or different salts.
Who Can Safely Use Salt Substitutes?
The analysis paid particular consideration to individuals with hypertension and in addition examined a subgroup of adults thought-about secure candidates for salt substitutes. This included people with regular kidney perform and people not taking drugs or dietary supplements that affect potassium ranges.
Some salt substitutes include potassium, which might construct as much as harmful ranges in individuals with kidney illness or these taking sure drugs or dietary supplements. Excessive potassium ranges can result in irregular coronary heart rhythms. Due to this, individuals with hypertension ought to seek the advice of a well being care skilled earlier than making the swap.
Key Findings: Utilization Stays Surprisingly Low
The evaluation confirmed that salt substitute use has remained constantly low throughout the U.S. inhabitants:
- Use peaked at 5.4% in 2013-2014 however dropped to 2.5% by 2017-March 2020. Knowledge assortment for 2020 ended early because of the pandemic.
- Amongst individuals eligible to soundly use salt substitutes, solely 2.3% to five.1% reported utilizing them.
- Utilization was highest amongst people with hypertension managed by treatment (3.6%-10.5%), adopted by these whose blood strain remained uncontrolled regardless of remedy (3.7%-7.4%).
- Fewer than 5.6% of individuals with untreated hypertension or regular blood strain used salt substitutes.
- Individuals who ate at eating places three or extra occasions per week appeared much less probably to make use of salt substitutes, though this distinction was not statistically important after adjusting for demographic components.
“Salt substitute use remained unusual during the last 20 years together with amongst individuals with hypertension,” Wei stated. “Even amongst people with handled and poorly managed or untreated hypertension, most continued to make use of common salt.”
Consultants Name It a Missed Alternative
“This examine highlights an necessary and straightforward missed alternative to enhance blood strain within the U.S. — using salt substitutes,” stated Amit Khera, M.D., M.Sc., FAHA, an American Coronary heart Affiliation volunteer professional.
“The truth that use of salt substitutes stays so low and has not improved in 20 years is eye-opening and reminds sufferers and well being care professionals to debate using these substitutes, notably in visits centered on hypertension.”
Khera, who was not concerned within the analysis, is a professor of medication, scientific chief of cardiology, and director of preventive cardiology at UT Southwestern Medical Heart in Dallas.
Research Limitations and Future Questions
The researchers observe a number of limitations. Salt substitute use was self-reported, which can have led to underreporting or misclassification. The examine additionally grouped all sorts of salt substitutes collectively, so it couldn’t distinguish potassium-based merchandise from different options. As well as, the info didn’t observe how a lot salt substitute individuals used.
“Future analysis ought to discover why salt substitute-use stays low by investigating potential limitations, similar to style acceptance, price and restricted consciousness amongst each sufferers and clinicians,” stated Wei. “These insights could assist information extra focused interventions.”
Research Design and Participant Particulars
The evaluation included 37,080 adults ages 18 and older (37.9% had been aged 18-39, 36.9% had been aged 40-59 years, and 25.2% had been aged 60 and older). 50.6% of individuals had been girls, 10.7% self-identified as non-Hispanic Black, and 89.3% reported different racial and ethnic backgrounds.
Individuals had been grouped based mostly on whether or not they had hypertension (≥130/80 mm Hg) and whether or not they had been utilizing treatment: managed hypertension, uncontrolled hypertension, untreated hypertension, or regular blood strain.
Salt use was categorized as abnormal salt (iodized salt, sea salt, kosher salt), salt substitute (potassium-enriched or different salt substitute), or no salt use.
A subgroup evaluation centered on individuals eligible for salt substitutes, outlined as these with wholesome kidney perform (estimated glomerular filtration price ≥ 60) and no use of medicines or dietary supplements that have an effect on potassium ranges. Researchers additionally examined how typically individuals ate at eating places. All outcomes accounted for NHANES sampling strategies and survey design.
Analysis Highlights
- Salt substitutes stay not often used regardless of their skill to decrease sodium consumption and assist handle blood strain.
- Growing consciousness might assist enhance outcomes, particularly for individuals with difficult-to-treat hypertension.
- The examine was funded by the Nationwide Institutes of Well being.
Word: The examine featured on this article is a analysis summary. Abstracts offered at American Coronary heart Affiliation’s scientific conferences should not peer-reviewed, and the findings are thought-about preliminary till printed as a full manuscript in a peer-reviewed scientific journal.
