The China Salt Substitute Study (CSSS) A Low Sodium, High Potassium Salt Substitute Substantially Lowers Blood Pressure Levels Among High-Risk Individuals in Rural Northern China A salt substitute specially formulated to be both flavorful and effective has significantly reduced blood pressure in residents of northern, rural China at high-risk of heart complications, where home-pickled foods are a dietary mainstay and hypertension is rampant. If widely adopted, this simple approach could markedly cut the risk of stroke and other cardiovascular diseases. Dr. Bruce C. Neal, MD, PhD, (director of the cardiac and renal division of The George Institute for International Health, Sydney, Australia) and his colleagues randomly assigned 608 study participants to replace their usual supply of household salt with either a salt substitute or the study salt for 12 months. In rural China, most meals are prepared at home. Unlike many salt substitutes, which consist primarily of potassium chloride and leave a bitter after-taste, the salt substitute used in the study was formulated using 65% sodium chloride (table salt), 35% potassium chloride, and 10% magnesium sulfate. At the beginning of the study, blood pressure averaged 159/93 mmHg. After 12 months, systolic blood pressure was 5.4 mmHg lower among those using salt substitute when compared to the control group, a highly significant difference. According to Dr. Neal the important observation is that dietary intervention is producing a blood pressure reduction comparable to that achieved in many large-scale trials of blood pressure lowering drugs versus placebo.