The study, which is one of the largest dietary intervention studies ever conducted and published in the New England Journal of Medicine, showed that changing this simple dietary habit significantly lowers stroke, heart attack and death risks without any harmful effect on health.

Both high salt and low potassium intake are common, and both are associated with high blood pressure and an increased risk of stroke, heart disease, and premature mortality.

Using a salt substitute—which replaces some of the sodium chloride with potassium chloride—addresses both issues simultaneously.

While it is well established that salt replacements lower blood pressure, their effect on heart disease, stroke, and death was unknown until today.

To do their research, the research team enrolled 21,000 adults with either a history of stroke or poorly managed blood pressure from 600 villages in rural areas of five provinces in China—Hebei, Liaoning, Ningxia, Shanxi and Shaanxi between April 2014 and January 2015.

Participants in intervention villages received a salt substitute sufficient to meet all household cooking and food preservation requirements—approximately 20g per person per day. The residents of the other settlements continued to use ordinary salt.

Over 3,000 patients suffered a stroke during an average follow-up of nearly five years. Researchers discovered that those who used the salt substitute had a 14 percent lower risk of stroke, a 13 percent lower risk of total cardiovascular events (strokes and heart attacks combined), and a 12 percent lower risk of premature mortality.

The study authors said that because salt substitutes are relatively cheap (about US$1.62 per kilo versus US$1.08 per kilo for regular salt in China) they are likely to be very cost-effective too.

The study concludes that substituting a reduced-sodium, added-potassium ‘salt substitute’ for table salt considerably lowers the risk of stroke, heart attack, and mortality.

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