Tag: salt substitute

Categories : Cardiovascular DiseaseTags :

Salt Substitute is an Effective Way of Cutting Hypertension in Older Adults

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Replacing table salt with a salt substitute can reduce incidence of hypertension in older adults without increasing their risk of hypotension episodes, according to a recent study in the Journal of the American College of Cardiology. Participants using a salt substitute had a 40% lower incidence and likelihood of experiencing hypertension compared to those who used regular salt.

One of the most effective ways to reduce hypertension risk, one of the world’s leading health risks, is to reduce sodium intake. This study looks at salt substitutes as a better solution to control and maintain healthy blood pressure than reducing salt alone.

“Adults frequently fall into the trap of consuming excess salt through easily accessible and budget-friendly processed foods,” said Yangfeng Wu, MD, PhD, lead author of the study and Executive Director of Peking University Clinical Research Institute in Beijing, China.

“It’s crucial to recognise the impact of our dietary choices on heart health and increase the public’s awareness of lower-sodium options.”

Researchers in this study evaluated the impact of sodium reduction strategies on blood pressure in elderly adults residing in care facilities in China.

While previous studies prove that reducing salt intake can prevent or delay new-onset hypertension, long-term salt reduction and avoidance can be challenging.

The DECIDE-Salt study included 611 participants 55 years or older from 48 care facilities split into two groups: 24 facilities (313 participants) replacing usual salt with the salt substitute and 24 facilities (298 participants) continuing the use of usual salt.

All participants had blood pressure <140/90mmHg and were not using anti-hypertension medications at baseline.

The primary outcome was participants who had incident hypertension, initiated anti-hypertension medications or developed major cardiovascular adverse events during follow-up.

At two years, the incidence of hypertension was 11.7 per 100 people-years in participants with salt substitute and 24.3 per 100 people-years in participants with regular salt.

People using the salt substitute were 40% less likely to develop hypertension compared to those using regular salt. Furthermore, the salt substitutes did not cause hypotension, which can be a common issue in older adults.

“Our results showcase an exciting breakthrough in maintaining blood pressure that offers a way for people to safeguard their health and minimise the potential for cardiovascular risks, all while being able to enjoy the perks of adding delicious flavour to their favourite meals,” Wu said.

“Considering its blood pressure – lowering effect, proven in previous studies, the salt substitute shows beneficial to all people, either hypertensive or normotensive, thus a desirable population strategy for prevention and control of hypertension and cardiovascular disease.”

Limitations of the study include that it is a post-hoc analysis, study outcomes were not pre-specified and there was a loss of follow-up visits in many patients.

Analyses indicated that these missing values were at random, and multiple sensitivity analyses supports the robustness of the results.

In an accompanying editorial comment, Rik Olde Engberink, MD, PhD, researcher, nephrologist and clinical pharmacologist at Amsterdam University Medical Center’s Department of Internal Medicine, said the study provides an attractive alternative to the failing strategy to reduce the intake of salt worldwide, but questions and effort remain.

“In the DECIDE-Salt trial, the salt substitute was given to the kitchen staff, and the facilities were not allowed to provide externally sourced food more than once per week,” Olde Engberink said. “This approach potentially has a greater impact on blood pressure outcomes, and for this reason, salt substitutes should be adopted early in the food chain by the food industry so that the sodium-potassium ratio of processed foods will improve.”

Source: American College of Cardiology

Categories : Cardiovascular Disease Diet and NutritionTags :

Added Potassium Salt Substitute Greatly Cuts CVD Risk

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Replacing table salt with a low-sodium, added potassium ‘salt substitute’ significantly reduces rates of stroke, heart attack and death, one of the largest dietary intervention studies ever conducted.

Presented at the European Society of Cardiology Congress in Paris, and simultaneously published in the New England Journal of Medicine, the results also showed that there were no harmful effects from the salt substitute, such as hyperkalaemia.

High sodium intake and low potassium intake are widespread. Both are linked to hypertension and increased risks of stroke, heart disease and premature death. Using a salt substitute – where part of the sodium chloride is replaced with potassium chloride – addresses both problems at once. Salt substitutes are known to lower blood pressure but their effects on heart disease, stroke, and death were unclear, until now.

Lead researcher, Professor Bruce Neal of The George Institute for Global Health, said that the benefit could prevent millions of early deaths with the widespread adoption of salt substitutes.

“Almost everyone in the world eats more salt than they should.  Switching to a salt substitute is something that everyone could do if salt substitutes were on the supermarket shelves,’’ he said.

“Better still, while salt substitutes are a bit more expensive than regular salt, they’re still very low-cost – just a few dollars a year to make the switch.”

“As well as showing clear benefits for important health outcomes, our study also allays concerns about possible risks.  We saw no indication of any harm from the added potassium in the salt substitute.  Certainly, patients with serious kidney disease should not use salt substitutes, but they need to keep away from regular salt as well,” added Professor Neal.

The Salt Substitute and Stroke Study enrolled 21 000 adults with either a history of stroke or poorly controlled blood pressure from 600 villages in rural areas of China from 2014 to 2015.

Participants in intervention villages were provided enough salt substitute to cover all household cooking and food preservation requirements – a daily amount of 20g per person. Those in the other villages continued using regular salt.

Over five years’ average follow up, more than 3000 participants had a stroke. Use of salt substitute reduced stroke risk by 14 percent, total cardiovascular events (strokes and heart attacks combined) by 13 percent and premature death by 12 percent.

Professor Neal said that as salt substitutes are relatively cheap (US$1.62 per kg vs US$1.08 per kg for regular salt in China), they are likely very cost effective.

“Last year, a modelling study done for China suggested that about 400 000 premature deaths might be prevented each year by national uptake of salt substitute. Our results now confirm this. If salt was switched for salt substitute worldwide, there would be several million premature deaths prevented every year,” he said.    

“This is quite simply the single most worthwhile piece of research I’ve ever been involved with. Switching table salt to salt substitute is a highly feasible and low-cost opportunity to have a massive global health benefit.”

As a result of the study, George Institute researchers are calling for salt manufacturers to embrace salt substitution, the promotion of salt substitutes by governments, and the use of substitute salt by consumers.

Source: George Institute for Global Health