Influence of Salt Substitution on Cardiovascular Events and Demise

Summary

Track record

Salt substitutes with decreased sodium concentrations and amplified potassium levels have been revealed to lower blood tension, but their effects on cardiovascular and safety outcomes are unsure.

Techniques

We performed an open-label, cluster-randomized trial involving folks from 600 villages in rural China. The members had a heritage of stroke or were 60 years of age or older and experienced superior blood stress. The villages were being randomly assigned in a 1:1 ratio to the intervention team, in which the contributors employed a salt substitute (75% sodium chloride and 25% potassium chloride by mass), or to the handle team, in which the participants ongoing to use normal salt (100% sodium chloride). The key outcome was stroke, the secondary results had been major adverse cardiovascular gatherings and loss of life from any result in, and the basic safety final result was medical hyperkalemia.

Outcomes

A total of 20,995 individuals have been enrolled in the demo. The mean age of the contributors was 65.4 many years, and 49.5% had been woman, 72.6% experienced a history of stroke, and 88.4% a heritage of hypertension. The indicate duration of abide by-up was 4.74 many years. The rate of stroke was reduced with the salt substitute than with normal salt (29.14 occasions vs. 33.65 occasions for each 1000 individual-years amount ratio, .86 95% self-assurance interval [CI], .77 to .96 P=.006), as had been the fees of major cardiovascular gatherings (49.09 occasions vs. 56.29 situations for every 1000 individual-several years charge ratio, .87 95% CI, .80 to .94 P<0.001) and death (39.28 events vs. 44.61 events per 1000 person-years rate ratio, 0.88 95% CI, 0.82 to 0.95 P<0.001). The rate of serious adverse events attributed to hyperkalemia was not significantly higher with the salt substitute than with regular salt (3.35 events vs. 3.30 events per 1000 person-years rate ratio, 1.04 95% CI, 0.80 to 1.37 P=0.76).

Conclusions

Among persons who had a history of stroke or were 60 years of age or older and had high blood pressure, the rates of stroke, major cardiovascular events, and death from any cause were lower with the salt substitute than with regular salt. (Funded by the National Health and Medical Research Council of Australia SSaSS ClinicalTrials.gov number, NCT02092090.)