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Salt Substitute Cuts Strokes, CV Events, Deaths in Older Adults

Rates of stroke, major CV events, and death lower with salt substitute versus regular salt in older adults with hypertension, history of stroke

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FRIDAY, Sept. 17, 2021 (HealthDay News) -- Rates of stroke, major cardiovascular events, and death from any cause are lower among older adults using salt substitute rather than regular salt, according to a study published in the Sept. 16 issue of the New England Journal of Medicine.

Bruce Neal, M.B., Ch.B., Ph.D., from the George Institute for Global Health at the University of New South Wales in Sydney, and colleagues randomly assigned 20,995 individuals living in rural China (all of whom had a history of stroke [72.6 percent] or were ≥60 years with hypertension [88.4 percent]) to either use a salt substitute or continue using regular salt.

The researchers found that the rate of stroke was lower with the salt substitute than with regular salt (29.14 versus 33.65 events per 1,000 person-years; rate ratio, 0.86; 95 percent confidence interval, 0.77 to 0.96; P = 0.006). Similar results were seen for rates of major cardiovascular events (49.09 versus 56.29 events per 1,000 person-years; rate ratio, 0.87; 95 percent confidence interval, 0.80 to 0.94; P < 0.001) and death (39.28 versus 44.61 events per 1,000 person-years; rate ratio, 0.88; 95 percent confidence interval, 0.82 to 0.95; P < 0.001). Rates of serious adverse events attributed to hyperkalemia were similar between the groups (3.35 versus 3.30 events per 1,000 person-years; rate ratio,1.04; 95 percent confidence interval, 0.80 to 1.37; P = 0.76).

"Because it is primarily persons in low-income and disadvantaged populations who add large quantities of salt to their diet during food preparation and cooking, salt substitution -- a practical, low-cost intervention (about $1.62 per kilogram of salt substitute versus $1.08 per kilogram of regular salt in China) -- may have the potential to reduce health inequities related to cardiovascular disease," the authors write.

The salt substitute was donated by Jiangsu Sinokone Technology for years 3 to 4 of the study.

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