Salt alternatives can reduce the risk of stroke recurrence and death

Large clinical trials have shown that replacing regular salts with sodium-potasium blends provides simple, low-cost interventions for stroke patients.

Recent randomized clinical trials argue that salt substitutes are safer and more effective than regular salts in terms of reducing the risk of recurrent stroke and death in patients with a history of stroke. A detailed examination report is published on Jama Cardiology.

background

Strokes are a major cause of death and long-term disability, especially in low- and middle-income countries. The estimated rate of stroke recurrence is 10% per year and 15% per five years for patients with a history of stroke.

In China, the rate of stroke recurrence is significantly higher than global estimates, at 17% in one year and 41% in five years. This may be caused by the high prevalence of hypertension (hypertension) in China.

Controlling hypertension is considered an important strategy to reduce the risk of stroke. Several clinical trials have reported that dietary sodium reduction and potassium supplementation are associated with effective control of hypertension.

Salt alternatives that replace part of sodium with potassium have been found to have long-term blood pressure-lowering effects across diverse populations.

Salt substitute and stroke studies were an unblind, randomized clinical trial and were conducted in villages in China 600 north. In this trial, involving 20,995 participants, we previously reported that salt substitutes can significantly reduce the risk of stroke, total cardiovascular events and early death.

In the current study, the researchers conducted a secondary analysis of salt substitution and stroke research data to determine the effect of salt substitutions on recurrent stroke and mortality in patients with a history of stroke.

the study

This study included a subgroup of patients in the salt substitute and stroke studies who self-reported hospital diagnosis of stroke at baseline. This included 15,249 patients randomly assigned to the intervention and control groups.

Participants in the intervention group received a salt alternative consisting of 75% sodium chloride and 25% potassium chloride. In the control group, participants received the usual salt. The median follow-up period for the study was 61 months.

Important observations

This study reported that alternative salt consumption leads to a slight reduction in systolic blood pressure (-2.05 mm Hg) over a 61-month follow-up period. During this period, 2735 recurrent stroke events and 3242 deaths occurred among participants.

The rates of stroke recurrence in the intervention and control groups were 16% and 19%, respectively. This reduced the recurrence rate of participants who consumed salt alternatives by 14%.

The positive effect of salt substitutes on the rate of recurrence was stronger in hemorrhagic stroke compared to ischemic stroke.

In addition to the rate of stroke recurrence, salt alternative intake was associated with a 12% reduction in all-cause mortality and a 21% reduction in stroke-related mortality. The effect of salt alternatives on all-cause mortality was most pronounced for deaths associated with vascular causes.

In particular, no significant differences in hyperkalemia events (high blood potassium levels) were observed between the intervention and control groups, and salt alternatives are safe and the heart caused by interhypertensive potassium levels. It shows that it does not increase the risk of the event.

The importance of research

This study revealed that salt substitutes can be safely used in diets in patients with chlorinosis to reduce the risk of recurrent stroke and mortality.

These risk-reducing effects of salt alternatives are independent of participants' age, gender, educational status, body mass index, blood pressure, diabetes, and anti-therapeutic use.

Researchers believe that the health benefits of salt can be attributed to its blood pressure-lowering effects. In this context, existing evidence shows that dietary sodium reduction and potassium supplementation work synergistically to lower blood pressure.

Participants who consumed salt alternatives had a slightly lower systolic blood pressure (-2.05 mm Hg) over 61 months. Previously, even 1 mm Hg Hg in systolic blood pressure has been shown to lead to a 5% reduction in the risk of stroke.

These observations collectively suggest that substituting salt as a low-cost intervention as a salt intervention can be used in the diet of high-risk people for stroke management.

Researchers say such interventions are particularly appropriate and effective in rural China. Adults in these regions consume large amounts of sodium through the home cooking process and small amounts of potassium due to insufficient fruit and vegetable consumption.

Researchers have mentioned some limitations of the study. The interventions evaluated in this study were not blinded as salt substitutes and stroke studies were open levels. Furthermore, the findings should be considered exploratory as they are secondary subgroup analysis of salt substitution and stroke research data.

Despite these limitations, this study can provide safe and cost-effective dietary interventions for stroke survivors and significantly improve the secondary prevention of stroke and cardiovascular health on a global scale.