In addition, for every 1,000 mg increase in potassium, the risk also dropped 18% over the same period.
The findings, reported Saturday at the American Heart Association Scientific Sessions meeting and online by The New England Journal of Medicine, are expected to add pressure to consumers and the companies that process their food to lower sodium intake or substitute potassium-based products.
The authors took their data from six cohort studies where sodium and potassium levels were assessed using 24-hour urine samples, the best method available.
The study is further proof that "we need to be aware of the harmful effect of high sodium intake and low potassium intake to try to change our behaviors, to adapt to a low-sodium diet, and to try to look for low-sodium products in grocery stores," chief author Yuan Ma of the Harvard T. H. Chan School of Public Health told Reuters Health in a telephone interview.
"It's also important for companies and the government to make a consensus effort to help people adopt a low-sodium diet where low-sodium products are widely available for the customers to choose," she said.
Dr. Ma said she hopes the findings add to that pressure.
Last month, the U.S. Food and Drug Administration released guidelines encouraging food manufacturers, chain restaurants and food service operators to cut salt levels by 12% so that consumers would be getting an average of 3,000 milligrams of sodium per day over the next two and a half years.
That's still considered high and the American Heart Association said the target is not low enough, especially when more than 2 in 5 Americans already have high blood pressure, a leading cause of heart attack and stroke.
Most sodium in the U.S. diet comes from processed, packaged and prepared foods.
Dr. Ma, a research scientist in the department of epidemiology, characterized release of the guidelines as "encouraging."
The new study is significant, in part, because the researchers used repeated 24-hour urinary excretion to get the most reliable assessment of sodium and potassium intake.
Median sodium excretion from the urine samples was 3,270 mg and sodium intake - because not all sodium ends up in the urine - was estimated to be 3,516 mg daily.
The results were consistent with estimates from previous research about the scope of the benefits of cutting back on sodium and increasing potassium.
Foods high in potassium include bananas, oranges, sweet potatoes, cucumbers, mushrooms, peas, cooked spinach and broccoli, nuts, and lima, pinto and kidney beans.
The new study was funded by the American Heart Association and the National Institutes of Health.
Dr. Ma cautioned that most of the people in the study were white and generally healthy, so "the generalizability to other groups needs to be confirmed in future studies."
But the benefits of a low-salt, high-potassium diet were seen regardless of age, sex, weight and starting blood pressure, the researchers said.
SOURCE: https://bit.ly/308YF2D The New England Journal of Medicine, online November 13, 2021.
By Gene Emery
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