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salt substitute

70-75% sodium chloride, 25-30% potassium chloride Clinical significance: - lower 5 year risk of stroke or other major cardiovascular event & mortality (RR=0.97-0.98 for ~ 2 grams of daily sodium excretion vs regular salt use) [1] - salt substitute probably reduces blood pressure, non-fatal cardiovascular events & cardiovascular mortality in adults [2] - salt substitute probably increases blood potassium in adults [2] - these are small effects [2] - evidence is limited for adults without elevated blood pressure, for pregnant women & for people with other factors increasing serum potassium [2] - using a salt substitute may decrease the risk of developing hypertension in normotensive people [4] - evidence for protective effects of salt substitute on total mortality (RR=0.89), cardiovascular mortality (RR 0.87) & cardiovascular events (RR 0.89) [3] - overall reduction of systolic BP: -4.61 mm Hg; diastolic BP: -1.61 mm Hg [3] - salt substitution was more effective & less costly than salt restriction for hyptertension control & cardiovascular disease prevention than salt restriction in Chinese ElderCare failities [5] - salt substitution may reduce all-cause or cardiovascular mortality [6] - the evidence is uncertainm especially for a Western population - certainty of evidence is higher among persons following a Chinese diet Laboratory: - sodium in 24 hour hour & potassium in 24 hour hour confirm 10% decrease in sodium excretion & 50% increase in potassium excretion

Interactions

drug interactions

References

  1. Neal B, Wu Y, Feng X et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med 2021 Aug 29; [e-pub]. PMID: 34459569 https://www.nejm.org/doi/10.1056/NEJMoa2105675 - Ingelfinger JR. Can salt substitution save at-risk persons from stroke? N Engl J Med 2021 Aug 29; [e-pub] PMID: 34459568 https://www.nejm.org/doi/10.1056/NEJMe2112857
  2. Brand A, Visser ME, Schoonees A, Naude CE Replacing salt with low-sodium salt substitutes (LSSS) for cardiovascular health in adults, children and pregnant women. Cochrane Database Syst Rev. 2022 Aug 10;8(8):CD015207 PMID: 35944931 PMCID: PMC9363242 Free PMC article https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015207/full
  3. Yin X et al. Effects of salt substitutes on clinical outcomes: A systematic review and meta-analysis. Heart 2022 Aug 9; [e-pub]. PMID: 35945000 https://heart.bmj.com/content/early/2022/07/21/heartjnl-2022-321332
  4. Zhang X et al Effect of a Salt Substitute on Incidence of Hypertension and Hypotension Among Normotensive Adults. J Am Coll Cardiol. 2024 Feb, 83 (7) 711 PMID: 38355240 Clinical Trial. https://www.jacc.org/doi/10.1016/j.jacc.2023.12.013
  5. Lai X, Yuan Y, Wang H, et al. Cost-Effectiveness of Salt Substitute and Salt Supply Restriction in Eldercare Facilities: The DECIDE-Salt Cluster Randomized Clinical Trial. JAMA Netw Open. 2024 Feb 5;7(2):e2355564. PMID: 38345818 PMCID: PMC10862151 Free PMC article
  6. Greenwood H, Barnes K, Clark J, Ball L, Albarqouni L. Long-Term Effect of Salt Substitution for Cardiovascular Outcomes: A Systematic Review and Meta-Analysis. Ann Intern Med. 2024 Apr 9. PMID: 38588546 Review. https://www.acpjournals.org/doi/10.7326/M23-2626

Components

potassium chloride (KCl, Klor Con, Kaon-Cl, Slow-K, Micro-K, Klotrix, K Tab, K Dur, Ten-K, Cen-K, Kaochlor, Kay Ciel, K Lor, Kato, Klorvess, Kaon, K Lyte Cl) sodium chloride (NaCl, Adsorbonac Ophthalmic)