Reduction in sodium intake has been one of the much-practised health strategy for controlling blood pressure (BP) and reducing cardiovascular disease (CVD) risk. A review in The American Journal of Clinical Nutrition claimed that this singular focus may have fallen short, and that raising potassium intake should now be considered as a parallel approach to sodium reduction, and not as a secondary measure.
Hypertension affects over 1.28 billion adults worldwide and remains a leading modifiable driver of CVD. The World Health Organization (WHO) recommends sodium intake below 2000 mg/d and potassium intake above 3500 mg/d, yet average global sodium intake remains close to 4300 mg/d while potassium intake stays well below target in both developed and developing nations.
It further highlighted the China Salt Substitute and Stroke Study (SSaSS), in which a modest salt substitute (~75% sodium chloride/25% potassium chloride) reduced blood pressure and adverse cardiovascular outcomes, with modelling suggesting most of the benefit was driven by the added potassium, not by the sodium removed. A separate large feeding study (GenSalt) found that individual BP response to dietary salt is normally distributed rather than confined to a fixed ‘salt-sensitive’ subgroup, supporting population-wide rather than only individually targeted strategies.
These findings support a paradigm shift toward pairing sodium reduction with active potassium enhancement, through food reformulation, potassium-rich diets, and updated public health policy, as a more effective, comprehensive strategy for reducing the global burden of hypertension and cardiovascular disease.
Source: Fukagawa NK, Welling PA, Johnson J, Reimers K, Lee SY, Zecca P. Rethinking the impact of dietary sodium and potassium on blood pressure to advance public health. Am J Clin Nutr. 2026;124(2):101396. doi: 10.1016/j.ajcnut.2026.101396. Epub 2026 Jun 13. PMID: 42288189.