Potassium-enriched salt for patients with hypertension: a Hypertension Australia and National Hypertension Taskforce of Australia Position Statement.

INTRODUCTION

High blood pressure remains the leading risk factor for cardiovascular and all-cause deaths in Australia. Higher sodium and lower potassium intake are well established risk factors for elevated blood pressure and increased cardiovascular disease risk. Despite decades of global public health efforts, progress in reducing sodium and increasing potassium intake has been limited. The WHO recommends potassium-enriched salt as an effective, affordable, and scalable strategy to lower blood pressure by simultaneously reducing sodium and increasing potassium intake. This position statement was developed to support implementation and address this public health priority.

MAIN RECOMMENDATIONS

For patients with hypertension, core dietary recommendations should include reducing sodium by limiting the regular salt added when cooking and at the table, choosing low-salt foods and increasing potassium intake through fruit and vegetable intake. When these changes are challenging, switching regular salt with potassium-enriched salt offers a practical alternative. We recommend including this switch as an additional dietary recommendation in clinical hypertension guidelines. Suggested wording: 'If patients add salt to their food, they should make a 1 : 1 switch from regular salt to potassium-enriched salt with a composition of approximately 75% sodium chloride and 25% potassium chloride, unless they are at risk of hyperkalaemia because of kidney disease, use of a potassium supplement, use of a potassium sparing diuretic or for another reason." Routine kidney health checks are recommended to support safe implementation.

CHANGES IN MANAGEMENT

We advocate for the inclusion of this recommendation in future hypertension management guidelines. Systematic, nation-wide implementation of potassium-enriched salt as a replacement for regular salt should be prioritized as a scalable public health intervention. We call for further research into the impact of potassium-enriched salt in patients with kidney disease, the general population unscreened for hyperkalaemia risk, and patients using different antihypertensive regimens.