Meta-Analysis: Do Salt Substitutes Improve Blood Pressure and Clinical Outcomes?
BACKGROUND AND PURPOSE:
Yin et al. (Heart, 2022) performed a systematic review to summarize the effects of salt substitute on blood pressure and clinical outcomes for all available trials and assess the constancy of the findings across diverse populations
Systematic review and meta-analysis
Studies that report on the effects of salt substitutes on blood pressure or clinical outcomes
Meta-analyses and metaregression were used to define the consistency of findings across trials, geographies and patient subgroups
Effects of salt substitutes on blood pressure and clinical outcomes
21 trials | 31,949 participants
Salt substitutes were associated with an overall reduction of
Systolic BP: -4.61 mm Hg (95% CI, −6.07 to −3.14)
Diastolic BP: −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
History of hypertension
Baseline blood pressure
Baseline 24-hour urinary sodium
Baseline 24-hour urinary potassium
Metaregression showed that each 10% lower proportion of sodium choloride in the salt substitute was associated with a reduction in
Systolic BP: −1.53 mm Hg (95% CI, −3.02 to −0.03); P=0.045
Diastolic BP: −0.95 mm Hg (95% CI, −1.78 to −0.12); P=0.025
There were clear protective effects of salt substitutes on
Total mortality: RR 0.89 (95% CI, 0.85 to 0.94)
Cardiovascular mortality: RR 0.87 (95% CI, 0.81 to 0.94)
Cardiovascular events: RR 0.89 (95% CI, 0.85 to 0.94)
Salt substitutes appear to have a beneficial effect on BP across populations, geographies, and clinical subgroups
The authors state
Blood pressure-mediated protective effects on clinical outcomes are likely to be generalisable across population subgroups and to countries worldwide
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