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Why Your Body Prefers a Salt Substitute With Potassium

September 01, 2021

Of course you love salt! Everybody does. But try this experiment: Replace your favorite table salt, otherwise known as sodium chloride, with a salt substitute that’s at least 25 percent potassium.

The Salt Substitute and Stroke Study found 21,000 willing participants from 600 villages in five China provinces to do exactly that. These volunteers had a history of stroke or poorly controlled blood pressure, consequences of too much salt in their diet. The human body needs only about 500 milligrams of sodium each day for nerve and muscle function, balancing fluids in the blood and maintain a proper blood pressure. Americans are more likely to consume 3,400 milligrams, or 1.5 teaspoons, which increases hypertension (high blood pressure) and the risk of stroke, heart attack or death.

“Hypertension is the nexus for a lot of healthcare problems,” said Dr. Howard L. Haronian, Chief Medical Director and Vice President of the East Region of the Hartford HealthCare Heart & Vascular Institute.

The study’s results, presented Aug. 29 at the European Society of Cardiology Congress in Paris and published simultaneously in the New England Journal of Medicine, showed those who used salt substitute reduced stroke risk by 14 percent, cardiovascular events (strokes and heart attacks combined) by 13 percent and premature death by 12 percent.

Participants in certain villages received about 20 grams of salt substitute per day for each household member. Those in other villages continued their usual salt habits. Professor Bruce Neal of The Georgia Institute for Global Health, the study’s lead investigator, said a modeling study last year suggested 400,000 premature deaths in China might have been prevented by national use of salt substitute.

“Our results now confirm this,” he said.

In the study, those with the highest salt intake had a 20 percent greater risk of death from any cause than participants with the lowest salt intake.

Potassium might be the unsung hero of the study. Where high-volume salt increases blood pressure, potassium relaxes blood pressure and excretes sodium through urination as it decreases blood pressure. Study participants with the highest potassium intake had a 20 percent lower risk of dying than people with the lowest intake.

Want to lower your blood pressure?

Here are some tips:

• Resist salting everything you eat. The goal is less than 1,500 milligrams of salt a day. Even just reducing your intake by 1,000 milligrams will help.
• Eat more potassium. Bananas and potatoes can help you reach the daily goal of 3,500-5,000 milligrams.
• Lose weight. Dr. Haronian said adults can expect to drop one point in blood pressure for every pound lost.
• Eating a healthy diet. Fruits, vegetables, whole grains and low-fat dairy are the foundations.
• Exercise. Though aerobic and strength training are the best for your heart, even opting to park farther from the door or taking the stairs instead of the elevator will help. Keep your exercise regular, too, for the best results.
• Watch your alcohol intake. Dr. Haronian says the body is “agnostic to alcohol,” meaning it doesn’t matter if you drink wine, hard liquor or beer. But women should drink no more than one a day, and men no more than two.