Potassium concentrates promise to reduce the risk of recurrent stroke in clinical trials

Salt potassium supplements were associated with recurrent stroke and reduced mortality in large cluster randomized clinical trials involving patients from rural northern China. The findings are derived from subgroups (stroke patients) analysis within the Original Salt Substitute and Stroke Study (SSASS), an international study conducted in China.

Strokes are ranked as the top cause of low death and disability; Middle-income countriesand recurrence events remain a major concern. High sodium and low potassium intake are considered important risk factors, especially in northern China. In China, the rate of stroke recurrence is higher than the global average, reaching 17% in one year and 41% in five years.

The SSASS trial included 600 villages and 20,995 individuals in rural China. In previous studies, researchers replaced participants. salt 75% salt, 25% potassium chloride alternative.

This study states, “Salt Substitutions and Recurrent Stroke and Death: A Randomized Clinical Trial.” Published in Jama Cardiologythe team analyzed data from 15,249 participants who previously reported suffering from stroke.

The researchers used data from the original study that monitored safety outcomes, including blood pressure, stroke recurrence, mortality, and risk of hyperkalemia. Urinary sodium/potassium excretion was also tracked.

During the study period, recurrent stroke was the same as that found in the original complete cohort study, with 14% lower in the 25% potassium replacement group compared to the usual salt group.

average Systolic blood pressure Compared to controls, the salt substitute group had less follow-up period. A total of 2,735 recurrent stroke events occurred, with 691 fatal episodes and 2,044 nonfatal episodes.

Hemorrhagic stroke showed a relative decrease of 30%, and stroke-related deaths decreased by 21%. No meaningful differences in hyperkalemia were observed between groups.

The findings show that a 25% reduction in salts with potassium is a safe, low-cost dietary intervention that can reduce stroke recurrence and mortality among stroke survivors. Researchers suggest a wider implementation of salt alternatives, especially in areas where sodium intake is high and access to preventive health care is limited.

detail:
Xiong Ding et al, salt substitution and recurrent stroke and death; Jama Cardiology (2025). doi:10.1001/jamacardio.2024.5417

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