Symposium 2: Potassium-Enriched Salt in the new Australian Hypertension Guidelines: Evidence, Safety and Practice
| Thursday, December 3, 2026 |
| 1:40 PM - 2:40 PM |
Details
This symposium will examine the evidence, rationale, and practical implications underpinning the inclusion of potassium-enriched salt in the new Australian hypertension guidelines.
Excess sodium intake and inadequate potassium consumption are major contributors to elevated blood pressure and cardiovascular disease. Potassium-enriched salt substitutes, which partially replace sodium chloride with potassium chloride, have emerged as a scalable, evidence-based strategy to reduce blood pressure, stroke, and cardiovascular events at the population level.
The session will review the latest clinical and epidemiological evidence, including findings from major trials and international guideline developments, and discuss how these informed the Australian guideline recommendation. Importantly, the symposium will focus on the practical “how-to” of guideline implementation around potassium-enriched salt for clinicians, including identifying appropriate patients, screening for contraindications such as chronic kidney disease and use of potassium-retaining medications, counselling patients on safe use and practicalities around availability and cost, and integrating potassium-enriched salt recommendations into routine dietary and hypertension management discussions.
The symposium aims to equip clinicians and stakeholders with the knowledge and practical tools needed to translate the new recommendation into routine hypertension care and cardiovascular disease prevention.
Speaker
Dr Dannii Dougherty
Heart Foundation
From evidence to recommendation: appraising the evidence on potassium-enriched salt
Abstract
How does evidence on potassium-enriched salt move through a rigorous guideline development process?
Potassium-enriched salt offers a useful worked example of how emerging evidence is handled in contemporary guideline development. Dr Dannii Dougherty will provide insight into how evidence of this kind is systematically identified, assessed and translated into recommendations, including consideration of benefits, risks, feasibility and applicability to the local context.
Drawing on her work in clinical evidence at the Heart Foundation and experience contributing to national guideline development, Dr Dougherty will explain how the strength and certainty of evidence are assessed, how expert and consumer input is incorporated, and how recommendations are developed for use in clinical practice. Potassium-enriched salt illustrates how findings from large trials and systematic reviews are appraised as candidate evidence for national guidance.
For clinicians, understanding how this process works is important. It helps clarify how the evidence base for an intervention is weighed and what underpins any resulting guidance, particularly for an intervention that may still be unfamiliar in routine practice.
Potassium-enriched salt offers a useful worked example of how emerging evidence is handled in contemporary guideline development. Dr Dannii Dougherty will provide insight into how evidence of this kind is systematically identified, assessed and translated into recommendations, including consideration of benefits, risks, feasibility and applicability to the local context.
Drawing on her work in clinical evidence at the Heart Foundation and experience contributing to national guideline development, Dr Dougherty will explain how the strength and certainty of evidence are assessed, how expert and consumer input is incorporated, and how recommendations are developed for use in clinical practice. Potassium-enriched salt illustrates how findings from large trials and systematic reviews are appraised as candidate evidence for national guidance.
For clinicians, understanding how this process works is important. It helps clarify how the evidence base for an intervention is weighed and what underpins any resulting guidance, particularly for an intervention that may still be unfamiliar in routine practice.
Biography
Dr Dannii Dougherty is Head of Clinical Evidence at the Heart Foundation, an affiliate of the Health Evidence Synthesis, Recommendations and Impact (HESRI) group at Adelaide University, and a member of the steering group for the Guidelines International Network Australia and New Zealand (GIN ANZ) regional community. She has previously taught evidence-based practice and systematic review methodology at the University of South Australia.
With more than fifteen years' experience in evidence-based medicine, guideline methodology and knowledge translation, Dr Dougherty works to ensure that cardiovascular care and policy in Australia rest on rigorous, transparent evidence. She holds a Bachelor of Physiotherapy (Honours) and a PhD in Medicine.
Prof Mark Nelson
University of Tasmania
From guideline to consultation: integrating potassium-enriched salt into primary care. How does a GP turn that recommendation into something practical for a patient?
Abstract
Potassium-enriched salt is now part of the Australian hypertension guidelines. For general practice, the next challenge is making that recommendation useful in a routine consultation. Advice to “eat less salt” can be difficult for patients to translate into action. For people who add salt during cooking or at the table, switching to potassium-enriched salt offers a practical option. Possible actions for GPs include explaining what potassium-enriched salt is, helping patients identify an appropriate product, knowing where to buy it, understanding how to use it, and explaining how it fits with other blood pressure and lifestyle recommendations. This can and should be complimented by dietician referral especially in the setting of patient complexity. The focus is on making the guideline recommendation easy for clinicians to deliver and easy for patients to act on. It can sit alongside medication, healthy eating and other approaches to reducing cardiovascular risk.
Biography
Mark Nelson is Professor and Chair, Discipline of General Practice, and Senior Member, Menzies Research Institute for Medical Research, both at the University of Tasmania, and an Adjunct Professor, Department of Epidemiology and Preventive Medicine, Monash University, Australia. He is in general practice in Lindisfarne, Tasmania and was co-chair of the Expert Steering Group of the 2023 Guideline for assessing and managing CVD risk and Australian CVD risk calculator. His research interests are around large-scale clinical trials in CVD prevention in general practice. He has 500 scientific publications and has been a principal investigator on 3 of the 4 largest clinical trials conducted in Australia.
Dr Katrina Kissock
Research Fellow
The George Institute For Global Health
From feasibility to adoption: acceptability and implementation of potassium-enriched salt. What determines whether people and health systems actually take it up and sustain it?
Abstract
Despite strong evidence that a switch from regular salt to potassium-enriched salt lowers blood pressure and reduces cardiovascular risk, uptake remains low. Feasibility, acceptability and the settings in which people buy, recommend and use potassium-enriched salt all influence the adoption of this intervention in practice.
Dr Kissock will draw on implementation science and emerging evidence from Australia and other countries to examine the factors influencing adoption. Taste is often perceived as a barrier, yet studies show that potassium-enriched salt can be well accepted by consumers. Other factors including awareness, product familiarity, clinical confidence, availability, and affordability also influence whether people make and maintain the switch.
The presentation will consider how these findings can inform practical approaches to implementation. Priorities include strengthening clinician education and guidance, increasing consumer awareness, improving access to products, and working with retailers and manufacturers to improve availability and uptake.
Dr Kissock will draw on implementation science and emerging evidence from Australia and other countries to examine the factors influencing adoption. Taste is often perceived as a barrier, yet studies show that potassium-enriched salt can be well accepted by consumers. Other factors including awareness, product familiarity, clinical confidence, availability, and affordability also influence whether people make and maintain the switch.
The presentation will consider how these findings can inform practical approaches to implementation. Priorities include strengthening clinician education and guidance, increasing consumer awareness, improving access to products, and working with retailers and manufacturers to improve availability and uptake.
Biography
Dr Katrina Kissock is a Research Fellow at the George Institute for Global Health, Heart Foundation Postdoctoral Fellow, and Conjoint Lecturer at the University of New South Wales. Dr Kissock works across various research projects to support the switch from regular salt to potassium-enriched salt across the globe to improve cardiovascular health. Dr Kissock has research interests in cardiovascular disease, sodium reduction, whole grains, dietary intake, and public health and has worked across several international research collaborations. Dr Kissock is also an Accredited Practising Dietitian with experience working in chronic disease and youth mental health.
Prof Markus Schlaich
University of Western Australia
Managing risks in patients with chronic kidney disease
Abstract
Excess sodium intake and inadequate potassium consumption are major contributors to elevated blood pressure and cardiovascular disease. Potassium-enriched salt substitutes, which partially replace sodium chloride with potassium chloride, have emerged as a scalable, evidence-based strategy to reduce blood pressure, stroke, and cardiovascular events at the population level.
Potential concerns have been raised about the safety of potassium-enriched salt in patients with chronic kidney disease as affected patients are more prone to develop hyperkalaemia. This risk may be further increased by concomitant medications frequently used in this patient cohort such as renin-angiotensin-system inhibitors, mineralocorticoid receptor antagonists and others.
We will explore the evidence that is available in relation to the safety and efficacy of potassium-enriched salt substitution in chronic kidney disease and discuss clinical approaches to mitigate the risk of hyperkalaemia.
Potential concerns have been raised about the safety of potassium-enriched salt in patients with chronic kidney disease as affected patients are more prone to develop hyperkalaemia. This risk may be further increased by concomitant medications frequently used in this patient cohort such as renin-angiotensin-system inhibitors, mineralocorticoid receptor antagonists and others.
We will explore the evidence that is available in relation to the safety and efficacy of potassium-enriched salt substitution in chronic kidney disease and discuss clinical approaches to mitigate the risk of hyperkalaemia.
Biography
Prof Markus Schlaich is a renal physician and a European Society of Hypertension (ESH) accredited hypertension specialist. Markus is Chair of Hypertension Australia and Co-Chair of the National Hypertension Taskforce. He has a strong background in clinical research with a focus on the pathophysiology of hypertension, the role of the sympathetic nervous system, involvement of the kidneys, and hypertension mediated organ damage. He has a specific interest in treatment modalities targeting the sympathetic nervous system and has been a pioneer of renal denervation and other interventional and pharmacological approaches to treat hypertension. He has authored more than 550 articles in peer reviewed journals and serves on the Editorial Board of Hypertension, Journal of Hypertension, and Hypertension Research.
Session chair
Bruce Neal
Senior Professorial Fellow
The George Institute For Global Health
Alta Schutte
Professor Of Cardiovascular Medicine
UNSW Sydney | The George Institute for Global Health
