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Salt substitution programme successful in lowering blood pressure

ESC 2019
A Peruvian sodium reduction intervention lowered blood pressure across communities,. It had particular benefits in people with hypertension, and was also capable of reducing new cases of hypertension.

Salt consumption remains a worrisome feature in the diet of many people around the world. Researchers from the CRONICAS Centre of Excellence in Chronic Diseases at the Cayetano Heredia Peruvian University in Lima, Peru tested the use of a salt substitute which contained 75% sodium and 25% potassium. The salt substitute was made with equal parts of normal salt (100% sodium) and a commercially available low-sodium product (50% sodium, 50% potassium). Between 2014 and 2017, a randomised trial was conducted in 6 villages in a region which had high levels of sodium consumption and hypertension. Blood pressure of participants was measured at the beginning of the study and every 5 months thereafter (total: 7 measurements). A total of 2,376 people were involved in the study, and the mean age was 43 years. It emerged that the salt substitute reduced systolic blood pressure by an average of 1.23 mmHg and diastolic blood pressure by an average of 0.72 mmHg. These reductions were even greater in those who had hypertension at baseline, with 1.74 mmHg and 1.25 mmHg reductions for systolic and diastolic blood pressure, respectively. This intervention significantly reduced the chances of developing hypertension in people who had no hypertension at baseline (n=1,865) with a 51% reduction compared to using normal salt (HR 0.49; 95% CI 0.34 to 0.71; P<0.001). Thus, this study demonstrated that simple, highly acceptable, and cheap population-wide changes in sodium intake and blood pressure are feasible [1].

1. De Miranda JJ. Salt substitution and community-wide reductions in blood pressure and hypertension incidence. FP Number 5505. . ESC Congress 2019, 31 Aug-4 Sept, Paris, France.

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