Food Alternatives to Salt May Reduce Risk of Heart Attack, Stroke and Death | Health

The results of a recent study suggest that dietary salt substitutes reduce the risk of heart attack, stroke and death from all causes and cardiovascular disease, according to a pooled analysis of available evidence.

The results were published online in the journal Heart.

The beneficial effects of these substitutes are likely to apply to people around the world, the researchers say. (Also read: This is how much salt you need to avoid health problems)

Cardiovascular disease is the leading cause of death worldwide and high blood pressure is a major risk for early death. A diet high in sodium and low in potassium is known to raise blood pressure.

According to researchers, approximately 1.28 billion people worldwide suffer from high blood pressure, although more than half of them are undiagnosed.

Salt substitutes, in which a proportion of sodium chloride (NaCl) is replaced by potassium chloride (KCl), are known to help lower blood pressure.

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

To shed some light on this, the researchers scoured research databases for randomized clinical trials published up to the end of August 2021 reporting on the effects of a salt substitute on blood pressure. , cardiovascular health and early death.

Blood pressure, which is measured in mmHg, is made up of two numbers: systolic – the higher number that indicates how hard the heart pumps blood throughout the body; and diastolic – the lower number that indicates blood pressure when the heart fills with blood.

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

Study periods lasted from 1 month to 5 years. The proportion of sodium chloride in the salt substitutes varied from 33% to 75%; the proportion of potassium varied from 25 to 65 percent.

Pooled data analysis showed that salt substitutes lowered blood pressure in all participants. The overall systolic blood pressure reduction was 4.61 mm Hg and the overall diastolic blood pressure reduction was 1.61 mm Hg.

Reductions in blood pressure appeared to be consistent regardless of geography, age, gender, history of high blood pressure, weight (BMI), baseline blood pressure, and baseline levels of sodium and urinary potassium.

And every 10% lower proportion of sodium chloride in the salt substitute was associated with a 1.53 mmHg greater drop in systolic blood pressure and a 0.95 mmHg greater drop in diastolic blood pressure. There was no evidence that high dietary potassium was associated with adverse health effects.

A pooled data analysis of the results of five of these trials involving more than 24,000 participants showed that salt substitutes reduced the risk of early death from any cause by 11%, the risk of diseases by 13% heart attack or stroke by 13% and the risk of heart attack or stroke by 11%.

The researchers acknowledge some limitations to their findings, including that studies in the pooled data analysis varied in design and that there were relatively few data for people who did not have high blood pressure.

But they nonetheless point out that their findings echo those of SSaSS, the largest trial ever of a potassium-enriched salt substitute to date.

“Since blood pressure lowering is the mechanism by which salt substitutes confer their cardiovascular protection, the consistent reductions in blood pressure observed provide a strong argument for generalizing the ability of the cardiovascular protective effect observed in the SSaSS both outside of China and beyond,” they wrote.

“These findings are unlikely to reflect the game of chance and support the adoption of salt substitutes in clinical practice and public health policy as a strategy to reduce dietary sodium intake, increase dietary potassium intake , lower blood pressure and prevent major cardiovascular events,” they said. conclude.

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