Swapping salt for salt substitutes lowers risk of stroke and heart disease, study

Replacing regular salt with a salt substitute lowers blood pressure and protects against life-threatening heart conditions, stroke and all-cause death, research suggests.

High consumption of sodium chloride compound salt is known to increase blood pressure, leading to poor cardiovascular health and a significant risk of premature death.

However, research published in the journal Heart has revealed that switching regular salt to a salt substitute, in which some of the sodium chloride is replaced by potassium chloride, reduces these health risks.

The study compiled the results of 21 clinical trials, with nearly 32,000 participants, published through the end of August 2021 that reported the effects of salt substitutes on blood pressure.

The team found that salt substitutes reduced blood pressure in all participants, regardless of region, age, sex, weight, and blood pressure-related factors.

“Salt substitutes produce consistent blood pressure-lowering effects across geographies and diverse subsets of participants,” the researchers write.

No adverse effects of increased potassium chloride intake were detected. The effect of potassium chloride added to salt substitutes, however, has raised concerns for people with kidney disease, who should limit their dietary potassium intake.

When researchers conducted a smaller analysis of just over 24,000 participants, they found that switching to salt substitutes reduced the risk of heart attack, stroke and early death from any cause by 11%. The risk of cardiovascular disease was reduced by 13%.

Similar results were published last year in a study involving more than 20,000 participants with high blood pressure from 600 villages in China. It was not clear, however, whether the benefits of salt substitutes would be the same in other parts of the world.

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“These findings are unlikely to reflect chance and support the adoption of salt substitutes in clinical practice and public health policy as a strategy to reduce dietary sodium intake, increase dietary potassium intake, reduce blood pressure and prevent major cardiovascular events,” the researchers write about the new study.

More than 14 million people in the UK have high blood pressure, around 5 million of whom are undiagnosed, according to the British Heart Foundation (BHF). High blood pressure contributes to around half of all heart attacks and strokes in the UK.

Tracy Parker, heart health dietitian at the BHF, said: “This research is a useful reminder to reduce the amount of salt we have in our diets and to look for alternatives.”

But Parker warned: “Although low-salt substitutes have less sodium than regular salt, they still contain potassium which may not be suitable for some people with heart problems and other existing health conditions. If you want to take care your health, it’s better to eat less salt. Using different herbs and spices when cooking is a great way to add flavor and replace salt.”

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