PotassiumNEW2026-08

[Potassium substitution: is replacing sodium with potassium-enriched salts beneficial?].

Götzinger Felix, Kunz Michael, Lauder Lucas, Mahfoud Felix — Innere Medizin (Heidelberg, Germany)

Summary

This paper reviews how replacing some regular salt with potassium-enriched salt might impact heart health. It suggests that reducing sodium and increasing potassium could be a beneficial strategy, especially for managing high blood pressure and preventing related cardiovascular issues like heart attacks and strokes. However, more research is needed for heart failure patients.

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Key points

High sodium intake is consistently linked to elevated blood pressure and increased risk of heart disease.
Potassium has been shown to help lower blood pressure.
Replacing some dietary sodium with potassium-enriched salts may reduce heart problems and deaths in people with high blood pressure.
More research is needed to confirm these benefits for patients with heart failure.

What the study looked at

This review investigated whether swapping some regular salt for potassium-enriched salt could improve cardiovascular health outcomes. The authors synthesized findings from various research types, including large population studies (epidemiological studies), combined analyses of multiple studies (meta-analyses), and a specific trial where groups of people used different salt types. They examined the effects of both sodium and potassium on heart health. They found consistent evidence that too much sodium harms the heart, leading to higher blood pressure and increased risk of heart disease. Importantly, replacing some sodium with potassium-containing salt appears to lower blood pressure and reduce the risk of heart disease and death, particularly for individuals with high blood pressure. However, more robust evidence is still needed regarding its effects on patients with heart failure.

Dietary takeaway

While more research is always ongoing, this review highlights the potential benefits of reducing sodium and increasing potassium in your diet for heart health. Consider choosing whole, unprocessed foods naturally lower in sodium and higher in potassium, such as fruits, vegetables, and legumes. If you have high blood pressure, discuss with a healthcare professional if potassium-enriched salt substitutes are appropriate for you, as one study's findings are not definitive but contribute to our understanding.

Abstract

BACKGROUND: Hypertension is the leading cause of premature death globally, and acute decompensated heart failure is among the most common causes of hospitalization. Both conditions are adversely affected by high dietary sodium intake. In contrast, potassium has been shown to lower blood pressure. Substituting dietary sodium with potassium may therefore reduce morbidity and mortality associated with hypertension and possibly heart failure. OBJECTIVES: This review summarizes the current evidence on the cardiovascular effects of dietary sodium and potassium-containing salts. CURRENT DATA: Epidemiological studies consistently demonstrate that high sodium intake is associated with elevated blood pressure and increased rates of cardiovascular morbidity and mortality. Meta-analyses indicate that reducing sodium intake lowers blood pressure and reduces cardiovascular events. In a cluster-randomized trial, partial substitution of sodium chloride with potassium-enriched salt reduced cardiovascular morbidity and mortality in patients with hypertension. However, robust data on the effects of sodium restriction or potassium substitution on hard cardiovascular outcomes in patients with heart failure remain limited. CONCLUSIONS: High sodium intake has detrimental effects on cardiovascular health. Substituting sodium with potassium-containing salts represents a promising strategy to reduce morbidity and mortality associated with hypertension.

View on PubMed →DOI: 10.1007/s00108-026-02112-6