Implementing low-sodium salt substitutes in a diet can lead to a significant lowering of systolic and diastolic BP, according to a meta-analysis published in Heart.
Adrian V. Hernandez, MD, PhD, FACC, FESC, associate professor of comparative effectiveness and outcomes research in the department of pharmacy practice at the University of Connecticut, and colleagues conducted a systematic review and meta-analysis to examine the effect of low-sodium salt substitutes in reducing CVD.
“One of the several existing salt reduction strategies is the use of salt products containing lower concentration of sodium, usually replaced by potassium and other minerals,” Hernandez and colleagues wrote. “These low-sodium salt substitutes are available in industrialized as well as developing countries. If this alternative demonstrates effectiveness on outcomes, it could be targeted as simple public health intervention.”
The researchers analyzed 21 randomized controlled trials enrolling adult hypertensive or general populations comparing detected hypertension, systolic BP, diastolic BP, overall mortality, stroke and other CV factors. Low-sodium salt substitute formulations were heterogenous across studies.
Low-sodium salt substitutes decreased systolic BP (mean difference, –7.81 mm Hg; 95% CI, –9.47 to –6.15) and diastolic BP (mean difference, –3.96 mm Hg; 95% CI, –5.17 to –2.74) compared with the control group, the researchers reported.
Levels of urinary potassium (mean difference, 11.46 mmol per day; 95% CI, 8.36-14.55) and calcium excretion (mean difference, 2.39 mmol per day; 95% CI, 0.52-4.26) increased in those taking low-sodium salt substitutes, Hernandez and colleagues wrote. A decrease in urinary sodium excretion (mean difference, –35.82 mmol per day; 95% CI, –57.35 to –14.29) was also observed with low-sodium salt substitutes. There were no significant differences in detected hypertension, overall mortality, total cholesterol, triglycerides, glucose or BMI.
“We could not conclude on the effects of salt substitutes’ stroke or CV mortality due to the scarcity of data,” Hernandez and colleagues wrote. “Further, well-powered, phase 3 [randomized controlled trials] are necessary to elucidate the effects of low-sodium salt substitutes on clinical and intermediate outcomes in hypertensive and general populations.” – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.