Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, China

Background and aimsSalt substitute is considered an effective strategy to reduce sodium and increase potassium intake and thereby lower blood pressure in China, but its benefits and risks are uncertain in real-world data. This study is designed to compare the difference in the 1-year efficacy of sal...

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Main Authors: Hao Wu, Wenbin Ouyang, Jing Deng, Yongmei He, Lu Yin, Xia Cao, Zhiheng Chen, Pingting Yang, Yaqin Wang, Ying Li, Xin Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2024.1504152/full
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author Hao Wu
Wenbin Ouyang
Jing Deng
Yongmei He
Lu Yin
Xia Cao
Zhiheng Chen
Pingting Yang
Yaqin Wang
Ying Li
Xin Huang
author_facet Hao Wu
Wenbin Ouyang
Jing Deng
Yongmei He
Lu Yin
Xia Cao
Zhiheng Chen
Pingting Yang
Yaqin Wang
Ying Li
Xin Huang
author_sort Hao Wu
collection DOAJ
description Background and aimsSalt substitute is considered an effective strategy to reduce sodium and increase potassium intake and thereby lower blood pressure in China, but its benefits and risks are uncertain in real-world data. This study is designed to compare the difference in the 1-year efficacy of salt substitute and salt restriction on urinary electrolytes and blood pressure.Methods and resultsA total of 2,929 and 2,071 participants with the 24-h estimated urinary sodium excretion (eUNaE) above 2.36 g/d using salt substitute (SS) and salt restriction (SR) strategies, respectively, were followed for 1 year. Salt substitute users were further divided by potassium chloride (KCl) content (13% vs 25%) and duration (9–11 vs 12 months). The 24-h eUNaE and estimated urinary potassium excretion (eUKE) levels were calculated using the Kawasaki formula from spot urine sample. The SS group (n = 1,897) had lower eUNaE (3.82 ± 1.03 vs 4.05 ± 1.01 g/day, p < 0.01) than the SR group (n = 1,897) after 1 year. Both 13 and 25% KCl substitutes reduced eUNaE versus restriction (p < 0.05). The SS group had a higher eUKE than the SR group (2.09 ± 0.43 vs 1.71 ± 0.62 g/day, p < 0.01). The eUKE was higher with 25% versus 13% KCl substitutes, while the Na/K was lower with 25% versus 13% KCl substitutes (p < 0.05). No significant blood pressure differences occurred between the SS and SR groups (p > 0.05), whereas 25% KCl exposure was related to a lower level of SBP, regardless of whether it was compared with SR or 13% KCl.ConclusionCompared with salt restriction, salt substitute results in more sodium reduction and greater potassium increase. In spite of this, it does not result in better control of blood pressure, especially for the group receiving 13% KCl.
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publisher Frontiers Media S.A.
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series Frontiers in Nutrition
spelling doaj-art-4e5f2425b98b42adba0c809a5d0011f02025-08-20T02:49:00ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2024-12-011110.3389/fnut.2024.15041521504152Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, ChinaHao Wu0Wenbin Ouyang1Jing Deng2Yongmei He3Lu Yin4Xia Cao5Zhiheng Chen6Pingting Yang7Yaqin Wang8Ying Li9Xin Huang10Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Epidemiology, Hunan Normal University School of Medicine, Changsha, ChinaDepartment of Epidemiology, Xiangya School of Public Health, Central South University, Changsha, ChinaDepartment of Health Management, Aerospace Center Hospital, Beijing, ChinaMedical Research & Biometrics Center, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaDepartment of Health Management, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Health Management, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Health Management, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Health Management, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Health Management, The Third Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Epidemiology, Hunan Normal University School of Medicine, Changsha, ChinaBackground and aimsSalt substitute is considered an effective strategy to reduce sodium and increase potassium intake and thereby lower blood pressure in China, but its benefits and risks are uncertain in real-world data. This study is designed to compare the difference in the 1-year efficacy of salt substitute and salt restriction on urinary electrolytes and blood pressure.Methods and resultsA total of 2,929 and 2,071 participants with the 24-h estimated urinary sodium excretion (eUNaE) above 2.36 g/d using salt substitute (SS) and salt restriction (SR) strategies, respectively, were followed for 1 year. Salt substitute users were further divided by potassium chloride (KCl) content (13% vs 25%) and duration (9–11 vs 12 months). The 24-h eUNaE and estimated urinary potassium excretion (eUKE) levels were calculated using the Kawasaki formula from spot urine sample. The SS group (n = 1,897) had lower eUNaE (3.82 ± 1.03 vs 4.05 ± 1.01 g/day, p < 0.01) than the SR group (n = 1,897) after 1 year. Both 13 and 25% KCl substitutes reduced eUNaE versus restriction (p < 0.05). The SS group had a higher eUKE than the SR group (2.09 ± 0.43 vs 1.71 ± 0.62 g/day, p < 0.01). The eUKE was higher with 25% versus 13% KCl substitutes, while the Na/K was lower with 25% versus 13% KCl substitutes (p < 0.05). No significant blood pressure differences occurred between the SS and SR groups (p > 0.05), whereas 25% KCl exposure was related to a lower level of SBP, regardless of whether it was compared with SR or 13% KCl.ConclusionCompared with salt restriction, salt substitute results in more sodium reduction and greater potassium increase. In spite of this, it does not result in better control of blood pressure, especially for the group receiving 13% KCl.https://www.frontiersin.org/articles/10.3389/fnut.2024.1504152/fullsalt substitutereal-worldsalt restrictioncohortChina
spellingShingle Hao Wu
Wenbin Ouyang
Jing Deng
Yongmei He
Lu Yin
Xia Cao
Zhiheng Chen
Pingting Yang
Yaqin Wang
Ying Li
Xin Huang
Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, China
Frontiers in Nutrition
salt substitute
real-world
salt restriction
cohort
China
title Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, China
title_full Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, China
title_fullStr Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, China
title_full_unstemmed Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, China
title_short Effects of salt substitute on urinary electrolytes and blood pressure in a real-world setting—cohort study in Hunan, China
title_sort effects of salt substitute on urinary electrolytes and blood pressure in a real world setting cohort study in hunan china
topic salt substitute
real-world
salt restriction
cohort
China
url https://www.frontiersin.org/articles/10.3389/fnut.2024.1504152/full
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