A large-scale clinical trial conducted in rural communities of northern China revealed that partially replacing common salt with potassium-rich substitutes can reduce the recurrence of strokes and associated mortality, according to Medical Dialogues. The study, known as the Salt Substitute and Stroke Study (SSaSS), involved over 20,000 participants and is considered one of the largest investigations into the effects of salt consumption on health.
In an analysis of 15,249 patients who had previously suffered a stroke, the results showed that using salt substitutes reduced cases of recurrent strokes by 14% compared to the group that used regular salt. The study aimed to determine if replacing regular salt with a substitute containing 75% sodium chloride and 25% potassium chloride helps reduce the risk of a second stroke in people who have previously suffered a stroke.
Participants were assigned to use either a salt substitute composed of 75% sodium chloride and 25% potassium chloride by mass, or regular salt, which is entirely sodium chloride. The SSaSS trial included 20,995 participants from 600 rural villages, nearly 90 percent of whom were over 60 years old and had high blood pressure.
High sodium intake and low potassium intake are considered key risk factors for stroke, particularly in northern China. Potassium-rich salt substitutes can reduce the risks of stroke recurrence and death, presenting a cost-effective option for stroke survivors, especially in areas with excessive sodium consumption.
"The study suggests that potassium salt substitute significantly reduced the risks of stroke recurrence and death, and is a novel and practical therapeutic option for patients with stroke," said the researchers. They emphasized that "salt substitution was safe, along with reduced risks of stroke recurrence and death, which underscores large health gains from scaling up this low-cost intervention among patients with stroke."
Despite the increase in potassium intake, no differences were detected in the incidence of hyperkalemia between the groups. Using salt substitutes instead of regular salt did not increase the risk of hyperkalemia in stroke survivors, Medical Dialogues reported.
The study showed a decrease in blood pressure among participants in the salt substitute group, which is a contributing factor in preventing strokes.
Recurrent stroke events remain a major concern, and hypertension is a contributing factor to stroke recurrence. When scaled up and sustained over time, the simple intervention of salt substitution could improve secondary stroke prevention and cardiovascular health on a global scale.
"Salt substitution has the potential to shape global public health strategies for stroke prevention," the researchers concluded. They emphasized that, as a cost-effective dietary intervention, salt substitution offers health benefits.
Participants were closely monitored throughout the study, with baseline data collected through questionnaires and physical examinations that recorded height, weight, and blood pressure, along with information on demographics, medical history, medication use, and salt-related knowledge and behaviors. The cumulative recurrence rates in the salt substitute group and the normal salt group were 16.8% and 19.1%, respectively.
The average systolic blood pressure was lower in participants who used the salt substitute, suggesting an additional benefit in terms of hypertension control, one of the main risk factors for strokes. The study's methodology included rigorous monitoring of blood pressure, incidence of new strokes, mortality, and possible adverse effects such as the risk of hyperkalemia, a disorder related to elevated potassium levels in the blood.
The article was written with the assistance of a news analysis system.