Switching the salt in Indian kitchens to potassium-enriched salt could prevent about 4 lakh deaths a year, according to a study published in the journal Nature Health on 4 November. The research, carried out by The George Institute for Global Health with the University of New South Wales and Johns Hopkins University, modelled what would happen if the salt supply in 193 countries was replaced with a version in which part of the sodium chloride is swapped for potassium chloride. India stood out as the country with the most to gain. A full switch was projected to prevent 399,884 deaths and 1.52 million new cases of heart and kidney disease in India each year.
Across all 193 countries, a full switch was projected to prevent 2.96 million deaths and 10.17 million new cases of cardiovascular and chronic kidney disease each year. The team modelled a world in which potassium-enriched salt replaced regular salt in homes, factories and restaurants. The gains were large because high blood pressure is common: about one in three adults aged 30 to 79 worldwide lives with it, a total of around 1.4 billion people. Bruce Neal, Senior Professorial Fellow at The George Institute, said the health gains would be widespread and could avert as many as one in ten cardiovascular deaths in most countries.
Potassium-enriched salt and blood pressure
Potassium-enriched salt is made by replacing some of the sodium chloride in regular table salt with potassium chloride. In the standard mix used in the study, 25 per cent of the sodium chloride was removed and replaced with potassium chloride. The change tackles two problems at once: it cuts sodium intake and raises potassium intake. Both shifts lower blood pressure, and lower blood pressure reduces the risk of stroke, heart attack and kidney disease.
The figures come from modelling, not from counting deaths prevented in real life. The team tested five plans for rolling out potassium-enriched salt, from a full switch of all salt to a switch limited to people with diagnosed and treated high blood pressure. Swapping only the salt used at home was projected to prevent 1.85 million deaths a year worldwide. Changing only the salt in processed and restaurant food was projected to prevent 1.56 million deaths a year.
The modelling rests on trial evidence. A 2021 trial in seven rural villages in India followed 502 adults with high blood pressure for three months. One group cooked with regular salt while the other used a mix of 70 per cent sodium chloride and 30 per cent potassium chloride. The group using the mix saw systolic blood pressure fall by 4.6 mm Hg. A larger trial in China, the Salt Substitute and Stroke Study, followed participants for five years and found stroke rates 14 per cent lower, major cardiovascular events 13 per cent lower and premature death 12 per cent lower among those using potassium-enriched salt.
Potassium-enriched salt: who should avoid it
Potassium-enriched salt is not safe for everyone. The World Health Organization, which endorsed its use in 2025, excludes children, pregnant women and people with kidney problems or those taking medicines that change how the body handles potassium. Too much potassium in the blood can be dangerous for people whose kidneys cannot clear it. Anyone with kidney disease or on blood pressure medicines should ask a doctor before changing the salt they use.
Cost and taste are smaller barriers. The substitute is sold in many shops under brands such as LoSalt, and the price is close to that of regular salt. Cooks use it in the same way, in the same amounts. A national switch to potassium-enriched salt would still need manufacturers, shops and public food programmes to change what they stock and serve, and that change would take time and planning.
How India eats its salt
Indians eat 8 to 11 grams of salt a day on average, well above the level health bodies advise, and about 80 per cent of that sodium comes from salt added during cooking or at the table. That pattern is why changing the salt itself could reach so many people without asking them to change what they eat. India carries a heavy load of heart disease, and salt is one of the few risks that can be cut across a whole population through a single product change.
The World Health Organization endorsed potassium-enriched salt in 2025 as a way to reduce blood pressure and the risk of cardiovascular disease. The George Institute has published the full country estimates from the study, and the data for all countries are available on request. For India, the model puts the annual toll that a full switch could avoid at close to 4 lakh deaths and more than 1.9 million fatal and non-fatal heart and kidney events combined.