创作:szx 审核:szx 03月01日
  • 纳入2376名受试者进行一项随机试验,干预组摄入低钠盐(75%的NaCl+25%的KCl)以替代传统食盐,对照组继续摄入传统食盐;
  • 意向处理分析结果显示,相比于对照组,干预组受试者的平均收缩压降低1.29mm Hg,舒张压平均降低0.76mm Hg;
  • 在1891名干预开始前无高血压的受试者中,相比于对照组,干预组的高血压风险降低51%;
  • 干预组尿液中的钠水平未发生显著改变,而钾水平显著升高。
在一些对照研究中,将传统的食盐(以钠盐为主)替换为富含钾的低钠盐,可降低血压,尤其是高血压者的血压。Nature Medicine上发表的一项随机试验,在超过2000名秘鲁受试者中发现,将传统的食盐替换为富含钾的食盐(75%的NaCl+25%的KCl),可显著降低受试者的收缩压及舒张压,并显著降低高血压风险。
Nature Medicine [IF:36.13]

Effect of salt substitution on community-wide blood pressure and hypertension incidence



02-17, Article

Abstract & Authors:展开

Replacement of regular salt with potassium-enriched substitutes reduces blood pressure in controlled situations, mainly among people with hypertension. We report on a population-wide implementation of this strategy in a stepped-wedge cluster randomized trial (NCT01960972). The regular salt in enrolled households was retrieved and replaced, free of charge, with a combination of 75% NaCl and 25% KCl. A total of 2,376 participants were enrolled in 6 villages in Tumbes, Peru. The fully adjusted intention-to-treat analysis showed an average reduction of 1.29 mm Hg (95% confidence interval (95% CI) (−2.17, −0.41)) in systolic and 0.76 mm Hg (95% CI (−1.39, −0.13)) in diastolic blood pressure. Among participants without hypertension at baseline, in the time- and cluster-adjusted model, the use of the salt substitute was associated with a 51% (95% CI (29%, 66%)) reduced risk of developing hypertension compared with the control group. In 24-h urine samples, there was no evidence of differences in sodium levels (mean difference 0.01; 95% CI (0.25, −0.23)), but potassium levels were higher at the end of the study than at baseline (mean difference 0.63; 95% CI (0.78, 0.47)). Our results support a case for implementing a pragmatic, population-wide, salt-substitution strategy for reducing blood pressure and hypertension incidence.

First Authors:
Antonio Bernabe-Ortiz

Correspondence Authors:
J Jaime Miranda

All Authors:
Antonio Bernabe-Ortiz,Víctor G Sal y Rosas,Vilarmina Ponce-Lucero,María K Cárdenas,Rodrigo M Carrillo-Larco,Francisco Diez-Canseco,M Amalia Pesantes,Katherine A Sacksteder,Robert H Gilman,J Jaime Miranda

Nature Reviews Cardiology期刊

Is salt substitution ready for prime time?