Studies show that salt replacement reduces the risk of heart attack/stroke and death

A pooled analysis of the available evidence found that dietary salt replacement reduces the risk of heart attack, stroke, and death from all causes and cardiovascular disease.

According to the researchers, the beneficial effects apply to people everywhere.

Dietary salt substitutes reduce the risk of heart attack, stroke, and death from all causes and cardiovascular disease, according to a systematic review of the available evidence. The findings were published in the journal BMJ on August 9 heart.

Scientists believe that the beneficial effects of these substitutes may apply to people all over the world.

High blood pressure is a significant risk factor for premature death, and cardiovascular disease is the leading cause of death worldwide. A diet low in sodium and potassium can increase blood pressure.

About 1.28 billion people worldwide have high blood pressure, but more than half are undiagnosed, according to researchers.

Salt substitutes that replace sodium chloride (NaCl) with potassium chloride (KCl) are known to help lower blood pressure.

A recently published large study from China (the Salt Substitute and Stroke Study; SSaSS) found that salt substitutes reduced the risk of heart attack, stroke, and premature death. However, it was unclear whether these benefits would apply in other parts of the world.

To shed light on this, the researchers searched databases for randomized clinical trials published by the end of August 2021 that reported the effects of salt substitutes on blood pressure, cardiovascular health, and early death.

Blood pressure, mm Hg. is measured by and consists of two numbers: systolic – the highest number that shows the power of the heart to pump blood to the body; and diastolic—the bottom number that represents the arterial pressure when the heart is full of blood.

They pooled the results of 21 relevant international clinical trials involving nearly 30,000 people. These have been implemented in Europe, the Western Pacific, the Americas, and Southeast Asia.

The study period lasted from 1 month to 5 years. the share of sodium chloride as a salt substitute changed from 33% to 75%; the proportion of potassium is from 25% to 65%.

According to an analysis of the collected data, salt substitutes lowered blood pressure in all participants. The overall decrease in systolic blood pressure was 4.61 mm Hg.

The reduction in blood pressure appeared to be consistent regardless of geography, age, sex, history of high blood pressure, body mass index (BMI), baseline blood pressure, and baseline urinary sodium and potassium levels.

And each 10% lower proportion of the salt substitute sodium chloride was associated with an additional 1.53 mm Hg reduction in systolic blood pressure and an additional 0.95 mm Hg reduction in diastolic blood pressure. There has been no evidence that high potassium intake is harmful to human health.

An analysis of data from five of these trials with more than 24,000 participants showed that salt substitutes reduced the risk of early death from any cause by 11%, cardiovascular disease by 13%, and heart attack or stroke. 11%.

The researchers acknowledge certain limitations to their findings, including that the studies in the pooled data analysis varied in design and had relatively little data for people without high blood pressure.

However, they emphasize that their findings are similar to those of the largest trial of SSaSS, a potassium-enriched salt substitute.

“Since lowering blood pressure is a mechanism by which salt substitutes provide cardiovascular protection, the consistent blood pressure reduction observed in SSaSS provides strong evidence for the generalizability of the observed cardiovascular protective effect beyond China,” the authors write.

“These findings reflect chance play and do not support the adoption of salt substitutes in clinical practice and public health policy as a strategy to reduce sodium intake, increase dietary potassium intake, lower blood pressure, and prevent major cardiovascular events.” researchers conclude.

Reference: “Effect of Salt Substitutes on Clinical Outcomes: A Systematic Review and Meta-Analysis” Xuejun Yin, Anthony Rogers, Adam Perkovich, Liping Huang, Ka-Chun Li, Jie Yu, Yangfeng Wu, JHY Wu, Matti Marklund, Mark D Huffman , Jaime Miranda, Gianluca Di Tanna, Darwin Labart, Paul Elliott, Maoyi Tian and Bruce Neal, 9 Aug 2022, heart.
DOI: 10.1136/heartjnl-2022-321332

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