Salt Substitute Use Rare Among Adults With HTN: Daily Dose

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On September 5, 2025, we reported on a study presented at the American Heart Association's Hypertension Scientific Sessions in Baltimore, Maryland, that examined the long-term trends in salt substitute use among US adults.

The study

Investigators analyzed data from 37 080 adults aged ≥18 years who participated in the National Health and Nutrition Examination Survey (NHANES) between 2003 and March 2020. Participants were categorized by hypertension (HTN) status and treatment: controlled HTN with medication, uncontrolled HTN despite medication, untreated HTN, and normotension. An additional subgroup analysis evaluated individuals eligible to use salt substitutes, defined as those with normal kidney function and not taking medications or supplements affecting potassium levels. Salt use was classified as ordinary salt (eg, iodized, sea, kosher), salt substitutes (potassium-enriched or other formulations), or no salt.

The findings

Overall, fewer than 6% of US adults reported using salt substitutes at any point during the study period. Use peaked at 5.4% in 2013–2014 but declined to 2.5% by 2017–2020. Among adults eligible for salt substitute use, prevalence ranged from 2.3% to 5.1%.

In subgroup analyses, usage was highest among participants with treated, controlled HTN (3.6%–10.5%) and those with treated but uncontrolled HTN (3.7%–7.4%). Among individuals with untreated HTN or normal blood pressure, use remained consistently below 5.6%.

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