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Effects of salt sub...
Effects of salt substitutes on clinical outcomes : a systematic review and meta-analysis
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Yin, Xuejun (author)
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Rodgers, Anthony (author)
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Perkovic, Adam (author)
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Huang, Liping (author)
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Li, Ka-Chun (author)
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Yu, Jie (author)
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Wu, Yangfeng (author)
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Wu, J H Y (author)
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- Marklund, Matti (author)
- Uppsala universitet,Klinisk nutrition och metabolism,The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Huffman, Mark D (author)
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Miranda, J Jaime (author)
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Di Tanna, Gian Luca (author)
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Labarthe, Darwin (author)
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Elliott, Paul (author)
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Tian, Maoyi (author)
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Neal, Bruce (author)
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(creator_code:org_t)
- 2022-08-09
- 2022
- English.
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In: Heart. - : BMJ Publishing Group Ltd. - 1355-6037 .- 1468-201X. ; 108:20, s. 1608-1615
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- OBJECTIVES: The Salt Substitute and Stroke Study (SSaSS) recently reported blood pressure-mediated benefits of a potassium-enriched salt substitute on cardiovascular outcomes and death. This study assessed the effects of salt substitutes on a breadth of outcomes to quantify the consistency of the findings and understand the likely generalisability of the SSaSS results.METHODS: We searched PubMed, Embase and the Cochrane Library up to 31 August 2021. Parallel group, step-wedge or cluster randomised controlled trials reporting the effect of salt substitute on blood pressure or clinical outcomes were included. Meta-analyses and metaregressions were used to define the consistency of findings across trials, geographies and patient groups.RESULTS: There were 21 trials and 31 949 participants included, with 19 reporting effects on blood pressure and 5 reporting effects on clinical outcomes. Overall reduction of systolic blood pressure (SBP) was -4.61 mm Hg (95% CI -6.07 to -3.14) and of diastolic blood pressure (DBP) was -1.61 mm Hg (95% CI -2.42 to -0.79). Reductions in blood pressure appeared to be consistent across geographical regions and population subgroups defined by age, sex, history of hypertension, body mass index, baseline blood pressure, baseline 24-hour urinary sodium and baseline 24-hour urinary potassium (all p homogeneity >0.05). Metaregression showed that each 10% lower proportion of sodium choloride in the salt substitute was associated with a -1.53 mm Hg (95% CI -3.02 to -0.03, p=0.045) greater reduction in SBP and a -0.95 mm Hg (95% CI -1.78 to -0.12, p=0.025) greater reduction in DBP. There were clear protective effects of salt substitute on total mortality (risk ratio (RR) 0.89, 95% CI 0.85 to 0.94), cardiovascular mortality (RR 0.87, 95% CI 0. 81 to 0.94) and cardiovascular events (RR 0.89, 95% CI 0.85 to 0.94).CONCLUSIONS: The beneficial effects of salt substitutes on blood pressure across geographies and populations were consistent. Blood pressure-mediated protective effects on clinical outcomes are likely to be generalisable across population subgroups and to countries worldwide.TRIAL REGISTRATION NUMBER: CRD42020161077.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Näringslära (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nutrition and Dietetics (hsv//eng)
Keyword
- hypertension
- meta-analysis
- stroke
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Yin, Xuejun
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Rodgers, Anthony
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Perkovic, Adam
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Huang, Liping
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Li, Ka-Chun
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Yu, Jie
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show more...
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Wu, Yangfeng
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Wu, J H Y
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Marklund, Matti
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Huffman, Mark D
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Miranda, J Jaime
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Di Tanna, Gian L ...
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Labarthe, Darwin
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Elliott, Paul
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Tian, Maoyi
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Neal, Bruce
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show less...
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Heart
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Uppsala University