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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutritional Epidemiology
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1504152
This article is part of the Research Topic Dietary Strategies for Managing Hypertension and Hypotension: Insights and Mechanisms View all 6 articles

Effects of salt substitute on urinary electrolytes and blood pressure in a realworld setting ---cohort study in Hunan, China

Provisionally accepted
Hao Wu Hao Wu 1Wenbin Ouyang Wenbin Ouyang 2Jing Deng Jing Deng 3Yongmei He Yongmei He 4Lu Yin Lu Yin 5Xia Cao Xia Cao 1Zhiheng Chen Zhiheng Chen 1Pingting Yang Pingting Yang 1Yaqin Wang Yaqin Wang 1Xin Huang Xin Huang 2*Ying Li Ying Li 1*
  • 1 Department of Health Management, Third Xiangya Hospital, Central South University, Changsha, China
  • 2 Department of Epidemiology, College of Medicine, Hunan Normal University, Changsha, Hunan Province, China
  • 3 Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan Province, China
  • 4 Department of Health Management, Aerospace Clinical Medical College of Peking University, Beijing, Beijing, China
  • 5 National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Mentougou, Beijing, China

The final, formatted version of the article will be published soon.

    Background and Aims: Salt substitute is considered an effective strategy to reduce sodium and increase potassium intake and thereby lower blood pressure in China, but its benefits and risks are uncertain in real-world data. This study is designed to compare the difference in the 1-year efficacy of salt substitute and salt restriction on urinary electrolytes and blood pressure.: A total of 2,929 and 2,071 participants with the 24-hour estimated urinary sodium excretion (eUNaE) above 2.36 g/d using salt substitute (SS) and salt restriction (SR) strategies, respectively, were followed for one year. Salt substitute users were further divided by potassium chloride (KCl) content (13% vs 25%) and duration (9-11 vs 12months). The 24-hour eUNaE and estimated urinary potassium excretion (eUKE) levels were calculated using the Kawasaki formula from spot urine sample. The SS group (n=1,897) had lower eUNaE (3.82±1.03 vs 4.05±1.01 g/day, P< 0.01) than the SR group (n=1,897) after 1 year. Both 13% and 25% KCl substitutes reduced eUNaE versus restriction (P<0.05).The SS group had a higher eUKE than the SR group (2.09±0.43 vs 1.71±0.62 g/day, P< 0.01). The eUKE was higher with 25% versus 13% KCl substitutes, while the Na/K was lower with 25% versus 13% KCl substitutes (P<0.05). No significant blood pressure differences occurred between the SS and SR groups (P>0.05), whereas 25% KCl exposure was related to a lower level of SBP, regardless of whether it was compared with SR or 13% KCl.Compared with salt restriction, salt substitute results in more sodium reduction and greater potassium increase. In spite of this, it does not result in better control of blood pressure, especially for the group receiving 13% KCl.

    Keywords: salt substitute, Real-world, Salt restriction, cohort, China

    Received: 30 Sep 2024; Accepted: 30 Nov 2024.

    Copyright: © 2024 Wu, Ouyang, Deng, He, Yin, Cao, Chen, Yang, Wang, Huang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xin Huang, Department of Epidemiology, College of Medicine, Hunan Normal University, Changsha, 410013, Hunan Province, China
    Ying Li, Department of Health Management, Third Xiangya Hospital, Central South University, Changsha, China

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