A low-cost salt substitute reduces blood pressure in high-risk individuals
Original article
The China Salt Substitute Study Collaborative Group (2007) Salt substitution: a low-cost strategy for blood pressure control among rural Chinese: a randomized, controlled trial. J Hypertens 25: 2011–2018
Decreasing dietary salt intake is potentially a low-cost means of reducing the burden of blood-pressure-related disease. A recent paper reports on the blood pressure effects of using a salt substitute in rural Chinese individuals at high risk for vascular disease.
In a randomized double-blind trial, 608 individuals were provided with either normal salt (100% NaCl) or commercially available salt substitute (65% NaCl, 25% KCl, 10% MgSO4) to cover all household uses. Over the 12-month follow-up period, systolic blood pressure (equivalent at baseline) was a mean of 3.7 mmHg lower in the salt-substitute group than in the normal-salt group (P <0.001). The magnitude of this reduction seemed to increase with time (P = 0.001; maximal difference: 5.4 mmHg at 12 months). No differences in diastolic blood pressure were observed between the two groups at any time. First morning urine sodium concentrations were similar in the two groups at 6 and 12 months, but urine potassium concentrations were significantly higher in the salt-substitute group at both time points (by 6.8 mmol/l and 7.2 mmol/l, respectively). No incidences of severe hyperkalemia were recorded, and the rates of serious adverse events were similar in the two groups.
The study group concluded that salt substitution resulted in a sustained cost-effective clinically relevant reduction in systolic blood pressure. Salt substitution might be appropriate for high-risk individuals in developing countries, where the majority of dietary salt intake does not come from processed foods.
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Subject areas under which this article appears: Hypertension
