Health experts have said low-sodium potassium-enriched salt is much better at preventing high blood pressure than regular salt, but the alternative is rarely used by medical professionals.
High blood pressure, or hypertension, is linked to high sodium intake and impacts one in three Australians, leading to a greater risk of stroke and heart disease.
A large randomised trial by the George Institute for Global Health found that eating potassium-enriched salt substitutes lowered blood pressure the most out of all other treatment solutions, while providing needed potassium to the body.
"If the world switched from using regular salt to potassium-enriched it would prevent millions of strokes and heart attacks every year at very low cost," Alta Schutte, professor at the George Institute for Global Health, said.
The researchers also analysed 32 independent treatment plans for hypertension, including plans from over 25 countries' national health organisations.
They could only find two that specifically recommended the switch to a potassium-enriched salt to lower blood pressure - the Chinese and European treatment guidelines.
Now, health experts from Australia, the US, Japan, South Africa, and India are banding together to demand the solution be added to treatment plans globally.
"We found current clinical guidelines offer incomplete and inconsistent recommendations about the use of these salt substitutes," Schutte said.
"Given the wealth of evidence available, we feel it's time to include salt substitutes in treatment guidelines to help address spiralling rates of uncontrolled high blood pressure around the world."
What is potassium-enriched salt?
Potassium-enriched salt replaces sodium chloride in salt with potassium chloride.
It's made up of 75 per cent sodium chloride and 25 per cent potassium chloride, according to the George Institute for Global Health.
A study by the George Institute for Global Health found that reducing sodium intake and increasing potassium, was extremely effective at lowering blood pressure.
Potassium is an essential mineral that naturally occurs in many foods.
It is vital to the health of tissues in the human body, according to the Harvard T.H. Chan School of Health.
Low potassium has also been linked to high blood pressure.
Why hasn't salt substitution worked in the past?
Currently, people are consuming an estimated 4.3g of sodium a day, which is more than double the World Health Organisation's recommended intake of 2000mg a day.
Experts said one of the reasons salt substitution has failed previously is taste, as other substitutes dull the flavour of food.
However, the potassium-enriched substitute went nearly undetected by the people involved in the trial.
"Unwanted taste effects are the main reason why efforts to reduce salt intake have failed for more than two decades," Schutte said.
"The willingness of patients to keep using potassium-enriched salt removes that barrier which is why it can be a game-changer.
"We strongly encourage clinical guideline bodies to review their recommendations about the use of potassium-enriched salt substitutes at the earliest opportunity."
What are the proposed recommendations for switching salt?
The study's authors offered recommendations for patients with hypertension, as well as the regular population:
"Strong recommendation for patients with hypertension – Potassium-enriched salt with a composition of approximately 75 per cent sodium chloride and 25 per cent potassium chloride should be recommended to all patients with hypertension, unless they have advanced kidney disease, are using a potassium supplement, are using a potassium-sparing diuretic or have another contra-indication."
"Conditional recommendation for the general population – If you have to add salt to foods, potassium-enriched salt with a composition of approximately 75 per cent sodium chloride and 25 per cent potassium chloride can be recommended for use by the general population, in settings where there is a low likelihood that people with advanced kidney disease (stage 4-5) will be undiagnosed by the health system and contraindications to use can be printed on product packaging."
Professor Bruce Neal, executive director at The George Institute Australia, said that while the solution is useful, it shouldn't be used by patients with advanced kidney filler.
"Healthcare workers know not to recommend potassium-enriched salt in the presence of kidney disease and risks for these patients can be avoided," Neal said.
The study also mentioned that potassium-enriched salt needs to be widely available in supermarkets to remove an additional barrier to the treatment plan.
