salt substitute
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Introduction
70-75% sodium chloride, 25-30% potassium chloride
Laboratory
- sodium in 24 hour hour & potassium in 24 hour hour confirm 10% decrease in sodium excretion & 50% increase in potassium excretion
Clinical significance
- lower 5 year risk of stroke or other major cardiovascular event & mortality (RR=0.97-0.98 for ~ 2 grams of daily sodium excretion vs regular salt use)[1]
- salt substitute probably reduces blood pressure, non-fatal cardiovascular events & cardiovascular mortality in adults[2]
- salt substitute probably increases blood potassium in adults[2]
- these are small effects[2]
- evidence is limited for adults without elevated blood pressure, for pregnant women & for people with other factors increasing serum potassium[2]
- using a salt substitute may decrease the risk of developing hypertension in normotensive people[4]
- evidence for protective effects of salt substitute on total mortality (RR=0.89), cardiovascular mortality (RR 0.87) & cardiovascular events (RR 0.89)[3]
- overall reduction of systolic BP: -4.61 mm Hg; diastolic BP: -1.61 mm Hg[3]
- salt substitution was more effective & less costly than salt restriction for hyptertension control & cardiovascular disease prevention than salt restriction in Chinese ElderCare failities[5]
- salt substitution may reduce all-cause or cardiovascular mortality[6]
- the evidence is uncertainm especially for a Western population
- certainty of evidence is higher among persons following a Chinese diet
Components
- sodium chloride (NaCl, Adsorbonac Ophthalmic)
- potassium chloride (KCl, Klor Con, Kaon-Cl, Slow-K, Micro-K, Klotrix, K Tab, K Dur, Ten-K, Cen-K, Kaochlor, Kay Ciel, K Lor, Kato, Klorvess, Kaon, K Lyte Cl)
References
- ↑ 1.0 1.1 Neal B, Wu Y, Feng X et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med 2021 Aug 29; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34459569 https://www.nejm.org/doi/10.1056/NEJMoa2105675
Ingelfinger JR. Can salt substitution save at-risk persons from stroke? N Engl J Med 2021 Aug 29; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/34459568 https://www.nejm.org/doi/10.1056/NEJMe2112857 - ↑ 2.0 2.1 2.2 2.3 2.4 Brand A, Visser ME, Schoonees A, Naude CE Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women. Cochrane Database Syst Rev. 2022 Aug 10;8(8):CD015207 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35944931 PMCID: PMC9363242 Free PMC article https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015207/full
- ↑ 3.0 3.1 3.2 Yin X et al. Effects of salt substitutes on clinical outcomes: A systematic review and meta-analysis. Heart 2022 Aug 9; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35945000 https://heart.bmj.com/content/early/2022/07/21/heartjnl-2022-321332
- ↑ 4.0 4.1 Zhang X et al Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults. J Am Coll Cardiol. 2024 Feb, 83 (7) 711 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38355240 Clinical Trial. https://www.jacc.org/doi/10.1016/j.jacc.2023.12.013
- ↑ 5.0 5.1 Lai X, Yuan Y, Wang H, et al. Cost-Effectiveness of Salt Substitute and Salt Supply Restriction in Eldercare Facilities: The DECIDE-Salt Cluster Randomized Clinical Trial. JAMA Netw Open. 2024 Feb 5;7(2):e2355564. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38345818 PMCID: PMC10862151 Free PMC article
- ↑ 6.0 6.1 Greenwood H, Barnes K, Clark J, Ball L, Albarqouni L. Long-Term Effect of Salt Substitution for Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Ann Intern Med. 2024 Apr 9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38588546 Review. https://www.acpjournals.org/doi/10.7326/M23-2626