FRIDAY, Sept. 5, 2025 (HealthDay News) — Most people with high blood pressure aren’t skipping the salt shaker in favor of a salt substitute, according to a new study.

Incredibly few Americans use salt substitutes, essentially waving aside a simple and effective way to manage their blood pressure, researchers reported Thursday at an American Heart Association (AHA) meeting in Baltimore.

“Overall, less than 6% of all U.S. adults use salt substitutes, even though they are inexpensive and can be an effective strategy to help people control blood pressure, especially people with difficult-to-treat high blood pressure,” lead researcher Yinying Wei said in a news release. She is a doctoral candidate in applied clinical research and hypertension at UT Southwestern Medical Center in Dallas.

Salt substitutes replace some or all of the sodium with potassium, which tastes similar to regular salt, researchers said in background notes.

A salt-heavy diet causes the body to retain fluid, which can increase blood pressure by drawing more water into the bloodstream, according to the Cleveland Clinic.

For the new study, researchers analyzed data from the National Health and Nutrition Examination Survey gathered between 2003 and 2020, using food questionnaires to track use of salt substitutes.

Overall, salt substitute use among U.S. adults remained low during the study period. At most, more than 5% used salt substitutes during the 2013-2014 survey.

These results were similar when looking at adults who would benefit from salt substitutes. Only a little more than 5% used them overall, researchers found.

Use was most common in people with high blood pressure who were taking medications for the condition, with nearly 11% turning to salt substitutes.

Next most common were people with drug-resistant high blood pressure, with more than 7% using salt substitutes.

However, salt substitute use remained consistently less than 6% among people with untreated high blood pressure, researchers found.

“Salt substitute use remained uncommon over the last two decades including among people with high blood pressure,” Wei said. “Even among individuals with treated and poorly managed or untreated high blood pressure, most continued to use regular salt.”

These results highlight “an important and easy missed opportunity to improve blood pressure in the U.S. — the use of salt substitutes,” Dr. Amit Khera said in a news release. Khera is clinical chief of cardiology and director of preventive cardiology at UT Southwestern Medical Center in Dallas.

“The fact that use of salt substitutes remains so low and has not improved in two decades is eye-opening and reminds patients and health care professionals to discuss the use of these substitutes, particularly in visits focused on high blood pressure,” added Khera, who was not involved in the study.

The AHA recommends consuming no more than 2,300 milligrams of sodium daily, with an ideal limit of less than 1,500 mg per day for most adults.

For most people, cutting sodium back by 1,000 mg a day can improve their blood pressure and heart health, researchers said.

Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The Cleveland Clinic has more on the potential harms from excess salt.

SOURCE: American Heart Association, news release, Sept. 4, 2025