Salt substitutes are an inexpensive, simple way to lower sodium intake and help manage blood pressure. Yet fewer than 6% of U.S. adults use them, according to preliminary research presented at the American Heart Association’s Hypertension Scientific Sessions 2025.
The analysis drew on nearly 20 years of national health survey data and found that use of salt substitutes peaked at just over 5% before declining to 2.5% by 2020. Among people with high blood pressure, including those on medication, use remained consistently low.
“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,” said lead author Yinying Wei, M.C.N., R.D.N., L.D., a PhD candidate at UT Southwestern Medical Center.
Salt substitutes typically replace some or all of the sodium with potassium. They taste similar to table salt, though some have a slightly bitter aftertaste when heated. For most adults, they are safe and effective, but people with kidney disease or those taking certain medications or supplements should avoid them, since too much potassium can cause dangerous heart rhythm problems. Experts recommend talking with a health care provider before making the switch.
Despite the low rates of use, studies suggest even small reductions in sodium, about 1,000 milligrams a day, can improve blood pressure and heart health. The American Heart Association recommends limiting sodium to no more than 2,300 mg a day, with an ideal target of 1,500 mg.
“This study highlights an important and easily missed opportunity to improve blood pressure in the U.S. — the use of salt substitutes,” said Amit Khera, M.D., M.Sc., an American Heart Association volunteer expert who was not involved in the research.
The researchers say more work is needed to understand why salt substitutes remain underused. Barriers may include taste preferences, cost and lack of awareness among both patients and healthcare providers.
This study was supported by the National Institutes of Health. Findings were presented at the American Heart Association’s Hypertension Scientific Sessions 2025 and are considered preliminary until published in a peer-reviewed journal.