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Life Guide U.S. essentials
English

Switch the table salt at home to low-sodium salt (potassium salt)

  • Moderate value
  • Evidence A
  • Buys life
  • Disputed
  • Costs a little
  • Takes minutes
  • No willpower

In plain words

For people who have had a stroke, or are 60 or older with high blood pressure, switching the salt at home to low-sodium salt lowers the chance of death within five years by about 12% and of stroke by about 14%.

Cost

A bag costs a few CNY more than regular salt. You swap it when you buy, so it takes no extra time. The taste is almost the same.

What you get

A randomized trial, done in rural China, enrolled 20995 people who had all had a stroke or were hypertensive patients aged 60 or older, and followed them for 4.74 years. Result: the group using low-sodium salt had about 12% lower risk of death than the group using regular salt (RR 0.88). Stroke was about 14% lower (RR 0.86). Major cardiovascular events were about 13% lower (RR 0.87). For events of too much potassium in the blood, no statistically significant difference was seen between the two groups.

Notes

Disputed. The PURE study only followed people over the long term and did not assign groups. It reported that people who excreted less than 3 g of sodium a day had about 27% higher risk of death plus cardiovascular events, and people who excreted 7 g or more a day had about 15% higher risk. By its results, both too little and too much are bad, and somewhere in the middle is best. But in the rural Chinese randomized trial cited here, low-sodium salt only replaced part of the salt and does not push sodium that low. Also note that the people in the trial were high-risk older adults. Healthy young people would get much less benefit from switching. People with reduced kidney function, or who are taking potassium-sparing drugs, should ask their doctor before switching salt.

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Neal B 等 (2021). Effect of Salt Substitution on Cardiovascular Events and Death. NEJM. https://doi.org/10.1056/NEJMoa2105675
  2. O'Donnell M 等 (2014). Urinary sodium and potassium excretion, mortality, and cardiovascular events. NEJM. https://doi.org/10.1056/NEJMoa1311889（争议方 PURE）

Translated from the Chinese original. Original book, section 2, tip 9. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer