Replacing ordinary table salt with a potassium-enriched version could prevent nearly 3 million deaths and about 10 million cases of cardiovascular and kidney disease worldwide every year, according to a modeling study published Nov. 4 in Nature Health. In the United States alone, a full switch could prevent an estimated 104,787 deaths annually.

The study, led by The George Institute for Global Health, modeled scenarios across 193 countries. Potassium-enriched salt replaces part of the sodium chloride in regular salt with potassium chloride. "It looks, tastes, and cooks like regular salt," the institute said in its release.

The headline number comes from a best-case model, not an observed result — and the product is not safe for everyone. People with serious kidney disease and those on medicines that raise blood potassium need medical advice before using it, because too much potassium in the blood can cause dangerous heart rhythms.

Projections Across 193 Countries

High sodium and low potassium intake are established causes of high blood pressure, which drives strokes, heart attacks and kidney disease. About 1.4 billion adults aged 30 to 79 have hypertension, and cardiovascular disease caused 19.2 million deaths in 2023.

The researchers tested several scenarios. Switching only the salt used at home could prevent about 1.85 million deaths and 6.19 million disease cases a year. Switching only the salt in processed and restaurant foods could prevent about 1.56 million deaths and 5.46 million cases. Doing both yielded the 2.96 million deaths and 10.17 million cases figure.

A narrower, more realistic option targeted people already diagnosed with or treated for high blood pressure. If 80 percent of diagnosed people switched their home salt, the model projected about 590,000 deaths prevented each year. The biggest projected gains were in China, at about 1.08 million deaths, and India, at nearly 400,000, where most salt is added during home cooking. Other estimates included about 30,464 deaths prevented a year in Mexico and 12,951 in the United Kingdom, where the switch could also prevent around 60,000 disease cases annually, Euronews reported.

Bruce Neal, a senior professorial fellow at The George Institute, said the gains could avert up to one in ten cardiovascular deaths in most countries. He also called a full global shift "aspirational," describing the study as a starting point for countries to plan their own strategies.

The Evidence Behind the Projection

This is a modeling study. It combines estimates of salt intake, blood pressure effects, and disease risk to project outcomes, rather than measuring deaths in people who switched. Its results depend on those assumptions, including how many people would adopt the product.

The underlying evidence is stronger than the model alone. The World Health Organization endorsed potassium-enriched salt in 2025 to lower blood pressure and cardiovascular risk, based in part on randomized trials. The largest, the Salt Substitute and Stroke Study, followed about 21,000 people in rural China and found fewer strokes, major cardiovascular events and deaths among those using the substitute.

Disclosures matter for context — especially for a study with a clear policy goal. The release lists no funder for the modeling study, while several authors reported research support from Resolve to Save Lives, a global health organization that promotes blood pressure control. That support was disclosed in the paper's conflict-of-interest statement.

Who Should Avoid It or Ask a Doctor First

The main risk is hyperkalemia, a buildup of potassium in the blood that can disturb heart rhythm. People with advanced kidney disease are most at risk because their kidneys cannot clear extra potassium efficiently.

People taking medicines that significantly raise blood potassium also need caution. These can include some drugs prescribed for high blood pressure or heart failure, as well as potassium supplements. Anyone with kidney disease or on such medicines should talk to a doctor or pharmacist before switching.

The researchers found benefits outweighed risks even among patients with advanced kidney disease at the population level. "Risks for this group can be managed effectively through patient education, product labelling, and clinical oversight," said Vivek Jha, a nephrologist and senior professorial fellow at The George Institute in India. That population finding does not replace individual medical advice.

Cost is part of the appeal. Jha described the approach as having "much lower cost than many drug-based treatments," which matters in countries where blood pressure medicines are hard to obtain or afford.

For most healthy adults, switching is a simple change. Products are sold in many U.S. grocery stores, usually near regular salt. Reading labels for the potassium chloride share helps, and cutting overall salt still matters.

Processed Food and Potash Supply Set the Limits

In Europe and North America, more than 70 percent of salt intake comes from processed and restaurant foods, not the salt shaker. "To realise the maximum benefits from switching to potassium-enriched salt, we need to see the food industry take part, Neal said. That makes U.S. gains depend heavily on manufacturers, not just home cooks.

A global switch would also have a natural-resource dimension. Potassium chloride is mined from ancient evaporite deposits, the same potash used as crop fertilizer, and the researchers said production would need to scale up to meet new demand. Countries would need to weigh food-grade supply alongside agricultural needs.

The next steps are country-level. Researchers say strategies must fit how each population consumes salt, from labeling and pricing in home-cooking countries to reformulation rules for packaged foods. Readers interested in switching should start with a conversation with their health care provider if they have kidney disease or take regular medication.

What Readers Want to Know

What is potassium-enriched salt? A salt in which part of the sodium chloride is replaced with potassium chloride. The George Institute says it looks, tastes, and cooks like regular salt.

How many deaths could it prevent? A full global switch at home and in processed foods could prevent about 2.96 million deaths a year, according to the model, including about 104,787 in the United States.

Is this proven? The death figures come from a modeling study, not a trial. Separate randomized trials have shown salt substitutes reduce blood pressure and cardiovascular events.

Who should avoid potassium-enriched salt? People with serious kidney disease and those taking medicines that raise blood potassium should consult a doctor or pharmacist first.

Where does most salt come from in the U.S.? More than 70 percent of salt intake in North America comes from processed and restaurant foods, so food industry changes matter most.

Where does the potassium come from? Potassium chloride is mined from potash deposits, and production would need to expand for a global switch.