In a national cross-sectional survey of 3,283 Canadian adults, only 39.6% knew about potassium-enriched low-sodium salt substitutes (LSSS) and 11.1% used them currently, although 69.3% had tried one at some point. Awareness and use ran higher in people with hypertension (48.1% vs 36.2% awareness; 13.7% vs 9.8% use). Awareness was lowest at ages 35-44, and 55.4% supported government LSSS policy.
The gap between trying and sticking with LSSS is the key signal. Randomized evidence, notably the SSaSS trial in rural China (about 21,000 participants with prior stroke or hypertension), showed that swapping regular salt for a 75% sodium chloride/25% potassium chloride blend cut stroke, cardiovascular events and death. Yet this survey suggests those benefits do not translate into habit: most people who tried LSSS dropped it, plausibly over taste, price or availability, though the truncated abstract leaves the barriers unspecified. The survey is self-reported and cross-sectional, so it shows neither health effects nor why people quit. It also cannot establish that LSSS use lowers actual intake. Adults with advanced kidney disease or on potassium-sparing drugs such as ACE inhibitors, ARBs or spironolactone should check with a clinician first, because potassium chloride can cause hyperkalemia. Editorially, this is confirmatory implementation data rather than a new finding: the trial evidence is strong, and the bottleneck is acceptability and access. Hypertensive adults, the group with the most to gain, show only modestly higher uptake, which points to a missed counselling opportunity.
