The proportion of dietary salt replaced with potassium-enriched salt in the SSaSS: implications for scale-up
Author(s)
Type
Journal Article
Abstract
BACKGROUND: The SSaSS (Salt Substitute and Stroke Study) recently reported definitive effects of a potassium-enriched salt on cardiovascular outcomes and death. Quantifying the amount of potassium-enriched salt used by trial participants is important for understanding the magnitude of the effect of potassium-enriched salt on risk reduction and how population-wide scale-up might be achieved. METHODS: Baseline and annual 24-hour urine samples were collected from subgroups of participants in SSaSS throughout the 5-year follow-up. The mean difference in 24-hour potassium excretion between the 2 groups was used to estimate the quantity of potassium-enriched salt consumed in the intervention group. The corresponding projected difference in sodium intake between groups was calculated and compared with the observed difference. RESULTS: The potassium-enriched salt group, compared to the regular salt group, had a mean increase in 24-hour urinary potassium excretion of 0.80 g/d (95% CI, 0.71-0.90), which equates to consumption of 8.8 g/d (95% CI, 7.8-9.9) of potassium-enriched salt. Based on 8.8 g/d potassium-enriched salt consumption, the projected difference in 24-hour urinary sodium excretion was -0.79 g/d. This compares to an observed difference of -0.35 g/d (95% CI, -0.55 to -0.15) and suggests that 72% of baseline regular salt intake was replaced by potassium-enriched salt. CONCLUSIONS: The smaller than anticipated between-group difference in sodium excretion likely results from the joint use of regular salt and potassium-enriched salt in the intervention group. Our findings suggest that even an incomplete replacement of regular salt with potassium-enriched salt can deliver significant health gains. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02092090.
Date Issued
2023-05
Date Acceptance
2022-12-26
Citation
Hypertension, 2023, 80 (5), pp.956-965
ISSN
0194-911X
Publisher
American Heart Association
Start Page
956
End Page
965
Journal / Book Title
Hypertension
Volume
80
Issue
5
Copyright Statement
© 2023 American Heart Association, Inc.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/36628969
Subjects
blood pressure
cardiovascular disease
potassium-enriched salt
salt substitute
scale-up
sodium reduction
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2023-01-11