Sodium-salt substitution in populations at high risk of cardiovascular and cerebrovascular diseases: risks, benefits, and preventive strategies

China is one of the countries with the highest salt intake in the world. Excessive dietary sodium consumption, which is widespread in the daily diets of Chinese residents, has become a major public health concern affecting population health. Compared with traditional approach of simply reducing salt intake, salt substitution strategies demonstrate greater feasibility and sustainability in achieving sodium reduction goals. This paper systematically reviews and synthesizes existing evidence to elucidate the cardiovascular and cerebrovascular health benefits of salt substitution strategies among high-risk populations. It further explores effective pathways for practical implementation and calls for strengthened policy guidance and public education, as well as multisectoral collaboration, to advance and consolidate nationwide sodium reduction efforts.