A post hoc analysis among older adults with normal blood pressure (BP) in a multicenter, cluster-randomized trial in China suggested that replacing usual salt with a salt substitute (62.5% NaCl, 25% KCl, and 12.5% flavorings) may reduce high BP incidence without increasing hypotension episodes. The analysis included 611 older adults (mean age 71.4 years) with normal BP (mean BP 121.9/74.4 mmHg). For 2 year intervention, compared with usual salt group (n = 298), there was a lower incidence of high BP in the salt substitute group (n = 313, 11.7 vs 24.3 per 100 person-years; adjusted HR: 0.60) and did not increase incidence of hypotension episodes in (9.0 vs 9.7 per 100 person-years). Mean systolic/diastolic BP did not increase from the baseline to the end of intervention in the salt substitute group (mean changes: −0.3 ± 11.9/0.2 ± 7.1 mm Hg) but increased in the usual salt group (7.0 ± 14.3/2.1 ± 7.5 mm Hg), resulting in a net difference of −8.0/2.0 mm Hg in systolic and diastolic BP between the groups. The findings provide the evidence of a strategy for population-wide prevention and control of high BP and cardiovascular disease. Source: https://www.jacc.org/
