Replacing regular table salt with a potassium-enriched alternative could prevent nearly four lakh deaths and more than 15 lakh new cases of cardiovascular and kidney disease in India every year, according to a new global study published in Nature Health.
The study, which assessed the potential health benefits of switching to potassium-enriched salt across 193 countries, estimated that India could avert 3,99,884 deaths annually, along with 15,28,494 cases of cardiovascular disease and chronic kidney disease. The combined reduction in fatal and non-fatal health events could be nearly 19.3 lakh a year.
The findings are significant for India, where high blood pressure remains a major public health challenge and cardiovascular disease is a leading cause of death. They also point to a relatively simple dietary intervention that could complement existing efforts to prevent and control hypertension.
Potassium-enriched salt is made by replacing a portion of the sodium chloride in ordinary salt with potassium chloride. It looks, tastes and can be used much like regular table salt but helps address two dietary risk factors for high blood pressure: excessive sodium consumption and inadequate potassium intake.
Researchers from The George Institute for Global Health examined different scenarios, including replacing household salt, salt used in processed and restaurant foods, and both sources combined. Their modelling suggested that a complete switch across household and commercially prepared food could prevent almost three million deaths and 10.17 million new cases of cardiovascular and kidney disease globally every year.
Even a more limited shift could deliver substantial health benefits. Replacing household table salt alone was estimated to prevent 1.85 million deaths and 6.19 million disease cases worldwide annually. Switching salt used in processed and restaurant foods could avert another 1.56 million deaths and 5.46 million cases.
Bruce Neal, Senior Professorial Fellow at The George Institute, said the health gains could be widespread, potentially preventing as many as one in 10 cardiovascular deaths in most countries.
“Consuming too much sodium and not enough potassium are well-established causes of high blood pressure – a major risk factor for life-threatening conditions like strokes, heart attacks and kidney disease. Switching to potassium-enriched salt addresses both these dietary issues at the same time, with substantial health benefits,” he said.
"While a global shift from regular salt to a potassium-enriched substitute is asprational, 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."
The World Health Organisation (WHO) endorsed the use of lower-sodium salt substitutes in its 2025 guidelines to help reduce blood pressure and cardiovascular disease risk. The latest findings add to the evidence supporting their potential as a population-level prevention strategy.
However, the benefits will depend on how salt is consumed in individual countries. In India, where home cooking remains an important source of dietary salt, encouraging households to adopt potassium-enriched alternatives could be an important starting point.
At the same time, the growing consumption of packaged and restaurant foods makes it necessary to examine the salt content of commercially prepared products.
The study also assessed whether the benefits would outweigh the risks for people with advanced kidney disease, who may be vulnerable to hyperkalaemia, or dangerously high potassium levels. Such patients, particularly those taking medicines that increase potassium levels, need medical supervision before using these substitutes.
Professor Vivek Jha, Senior Professorial Fellow at The George Institute in India and a nephrologist, said precautions were necessary for people with serious kidney disease and those taking medicines that significantly raise blood potassium levels.
“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,” he said.
The researchers said country-specific approaches would be essential to maximise the benefits. In Europe and North America, more than 70% of dietary salt comes from processed and restaurant foods, making industry participation particularly important. Scaling up potassium chloride production would also be necessary to meet increased demand.
The study, titled “Global health outcomes from replacing dietary sodium chloride with potassium-enriched salt,” used computational modelling to estimate the potential impact of different salt-replacement strategies rather than measuring outcomes from a population-wide intervention.
For India, the findings offer an opportunity to consider salt reformulation as part of a broader hypertension-control strategy, alongside reducing salt consumption, improving dietary habits, increasing blood pressure screening and ensuring access to treatment. However, the projected benefits will depend on safe implementation, public awareness and the availability of suitable alternatives, said the experts.
