Effects of salt substitution on cumulative blood pressure: a secondary analysis of the SSaSS

IF 7.7 1区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

European Journal of Epidemiology Pub Date : 2025-03-27 DOI:10.1007/s10654-025-01216-x

Xiaoxia Li, Liping Huang, Bo Zhou, Zhifang Li, Jixin Sun, Yan Yu, Hongyi Song, Maoyi Tian, Xuejun Yin, Bruce Neal, Yuhong Zhang, Yangfeng Wu, Yi Zhao

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引用次数: 0

Abstract

The effect of a potassium-enriched salt substitute on cumulative blood pressure (BP) remains unclear. This study aimed to assess the long-term effects of a potassium-enriched salt substitute versus regular salt on cumulative and conventional measures of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP). We analyzed data from the Salt Substitute and Stroke Study (SSaSS), a 5-year cluster randomized controlled trial in rural of China with 20,995 participants. The intervention used salt substitute; controls used regular salt. BP was measured for all participants at baseline, among subsamples at 12-month intervals, and for all alive at 60 months. Cumulative BP was calculated as the average between baseline and follow-up measures multiplied by the time between them (mmHg × year). Linear mixed models were used to assess the effects of salt substitution on BP outcomes at each follow-up visit. After a mean 4.74 years of follow-up, salt substitute compared to the regular salt lowered the cumulative SBP with a mean (SD) of 740 (85) vs. 750 (87) mmHg×year. Salt substitute also lowered cumulative MAP and PP, with means (SD) of 560 (58) vs. 566 (59) mmHg×year, and 306 (67) vs. 313 (68) mmHg×year, respectively. Similar beneficial effects of the salt substitute were observed for traditional measurements of SBP, MAP, and PP. There was no difference in either cumulative DBP (434 vs. 437 mmHg × year) or traditional DBP (85 vs. 86 mmHg). Salt substitute significantly reduced cumulative and traditional SBP, MAP, and PP, but not DBP.

Trial registration

SSaSS ClinicalTrials.gov number: NCT0 2,092,090.

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来源期刊

European Journal of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

21.40

自引率

1.50%

发文量

109

审稿时长

6-12 weeks

期刊介绍： The European Journal of Epidemiology, established in 1985, is a peer-reviewed publication that provides a platform for discussions on epidemiology in its broadest sense. It covers various aspects of epidemiologic research and statistical methods. The journal facilitates communication between researchers, educators, and practitioners in epidemiology, including those in clinical and community medicine. Contributions from diverse fields such as public health, preventive medicine, clinical medicine, health economics, and computational biology and data science, in relation to health and disease, are encouraged. While accepting submissions from all over the world, the journal particularly emphasizes European topics relevant to epidemiology. The published articles consist of empirical research findings, developments in methodology, and opinion pieces.