Dietary salt reduces risk of heart attack and stroke -

Hypertension: reduction in cardiovascular events with saline replacement

Salt substitutes, in which part of the sodium chloride (NaCl) is replaced with potassium chloride (KCl), reduce the risk of cardiovascular events such as heart attacks and strokes and reduce the risk of death premature by cardiovascular disease, according to a recent study.

An international working group recently published an extensive review on the subject of salt substitutes. The researchers pooled data from 21 clinical trials to comprehensively assess the effects of saline replacement. The results have now been presented in the renowned trade journal "Heart".

1.3 billion people suffer from high blood pressure worldwide

Cardiovascular disease is by far the leading cause of death worldwide. High blood pressure is a major risk factor for developing heart disease. About 1.3 billion people worldwide suffer from high blood pressure. About one in two people do not know they have high blood pressure.

Increased blood pressure due to too much sodium

A diet high in sodium and low in potassium can increase blood pressure. Normal table salt (NaCl) is high in sodium. In the case of salt substitutes, it is therefore sought to replace part of the sodium with potassium.

Diet salt consistently lowers blood pressure

In the review article, the effect of salt substitutes with potassium has now been examined. The research team summarized the results of 21 international clinical studies involving a total of nearly 30,000 people who were followed for up to five years.

Data analysis shows that the use of salt substitutes was consistently associated with a reduction in blood pressure. On average, systolic blood pressure dropped by 4.61 mm Hg and diastolic by 1.61 mm Hg.

Reductions in blood pressure due to salt diet were consistent and independent of geography, age, sex, history of hypertension, body weight (BMI), baseline blood pressure, and levels baseline of urinary sodium and potassium, reports the team.

The dietary salts used in the studies contained between 33 and 75% sodium chloride and between 25 and 65% potassium chloride.

Reduced risk of heart attack and stroke

Those who used the salt substitute had an 11% lower risk of premature death from cardiovascular disease, 11% lower risk of having a stroke and 13% lower risk of dying than those who ate regular table salt. A heart attack.

Dietary salt is probably beneficial for most people

"Since lowering blood pressure is the mechanism by which salt substitutes provide their cardiovascular protection, the consistent reductions in blood pressure observed support generalizability," conclude the scientists involved.

The task force advocates for the wider use of salt substitutes in clinical practice. Salt substitutes are suitable "as a strategy to reduce sodium intake, increase potassium intake, lower blood pressure, and prevent major cardiovascular events," the researchers conclude.

However, the team cautions that the results were pooled from different studies and the proportion of participants without high blood pressure was relatively low. Additional investigations on the subject of salt substitutes therefore seem appropriate. (vb)

Author and source information

Show now

This text corresponds to the specifications of the specialized medical literature, medical guidelines and current studies and has been verified by health professionals.


Graduate editor (FH) Volker Blasek


Xuejun Yin, Anthony Rodgers, Adam Perkovic, et al. : Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis; in: Heart (2022), heart.bmj.comBMJ Media Relations: Dietary salt substitutes reduce risk of heart attack/stroke and death (published: 09.08.2022),

Important Note:
This article contains general advice only and should not be used for self-diagnosis or treatment. It cannot substitute a visit to the doctor.