effects of salt substitutes on clinical outcomes

Last edited 08/2022 and last reviewed 08/2022

Trial evidence demonstrates that reduced dietary sodium consumption or potassium supplementation lowers blood pressure:

• sodium-reduced, potassium-enriched salt substitutes, in which a proportion of the sodium chloride (NaCl) in regular salt is replaced with potassium chloride (KCl), combine these blood pressure-lowering effects (1)

A review of 21 trials (n=31,949) found use of salt substitutes (e.g. potassium enriched substitutes) reduced systolic and diastolic blood pressure by 4.61 and 1.61mmHg respectively, and reduced overall (RR 0.89, 95%CI 0.85-0.94) and CV (0.87, 0.81-0.94) mortality (1)

• prior systematic reviews of salt substitutes have reported clear beneficial effects on blood pressure levels, but effects on clinical outcomes and the risk of premature death have been ill-defined due to sparse data
• study authors concluded that:
  • beneficial effects of salt substitutes on blood pressure across geographies and populations were consistent. Blood pressure-mediated protective effects on clinical outcomes are likely to be generalisable across population subgroups and to countries worldwide.

Reference:

• Yin X et al. Availability, formulation, labeling, and price of low-sodium salt worldwide: environmental scan. JMIR Public Health Surveill 2021;7:e27423.doi:10.2196/27423pmid:http://www.ncbi.nlm.nih.gov/pubmed/33985938
• Yin X, Rodgers A, Perkovic A, et al. Effects of salt substitutes on clinical outcomes: a systematic review and meta-analysis.Heart Published Online First: 09 August 2022. doi: 10.1136/heartjnl-2022-321332