Salt substitution: a low-cost strategy for blood pressure control among rural Chinese. A randomized, controlled trial Academic Article uri icon

abstract

  • Dietary sodium and potassium consumption is associated with blood pressure levels. The objective of this study was to define a practical and low-cost method for the control of blood pressure by modification of these dietary cations in rural Chinese.This study was a double-blind, randomized, controlled trial designed to establish the long-term effects of a reduced-sodium, high-potassium salt substitute (65% sodium chloride, 25% potassium chloride, 10% magnesium sulphate) compared to normal salt (100% sodium chloride) on blood pressure among high-risk individuals. Following a 4-week run-in period on salt substitute, participants were randomly assigned to replace their household salt with either the study salt substitute or normal salt for a 12-month period.The mean age of the 608 randomized participants was 60 years and 56% of them were female. Sixty-four percent had a history of vascular disease and 61% were taking one or more blood pressure-lowering drugs at entry. Mean baseline blood pressure was 159/93 mmHg (SD 26/14). The mean overall difference in systolic blood pressure between randomized groups was 3.7 mmHg (95% confidence interval 1.6-5.9, P < 0.001). There was strong evidence that the magnitude of this reduction increased over time (P = 0.001) with the maximum net reduction of 5.4 mmHg (2.3-8.5) achieved at 12 months. There were no detectable effects on diastolic blood pressure.Salt substitution produced a substantial and sustained systolic blood pressure reduction in this population, and should be actively promoted as a low-cost alternate or adjunct to drug therapy for people consuming significant quantities of salt.

authors

  • Li, Y
  • Liu, J
  • Song, D
  • Shi, J
  • Wang, H
  • Yang, Y
  • Li, J
  • Zhang, Y
  • Guo, D
  • Liang, S
  • Qi, J
  • Pan, R
  • Li, B
  • Yang, Z
  • Wu, Y
  • Yu, X
  • Zhao, L
  • Chen, B
  • Zhou, B
  • Hu, J
  • Han, R
  • Li, N
  • Neal, B
  • Barzi, F
  • Huxley, R
  • Jane, K
  • Ryan, S
  • Prescott, J
  • Rodgers, A
  • Lawes, C
  • Barlow, M
  • Fa'atui, J
  • Milne, A
  • Ng, C
  • Pink, S
  • Gray, B

publication date

  • October 2007