Department of Biomedicine, Aarhus University, Denmark (R.L.).
Now with Translational Genomics, AstraZeneca, Gothenburg, Sweden (R.L.).
Hypertension. 2024 Mar;81(3):415-425. doi: 10.1161/HYPERTENSIONAHA.123.19487. Epub 2023 Oct 12.
Excessive salt intake raises blood pressure, but the implications of this observation for human health have remained contentious. It has also been recognized for many years that potassium intake may mitigate the effects of salt intake on blood pressure and possibly on outcomes such as stroke. Recent large randomized intervention trials have provided strong support for the benefits of replacing salt (NaCl) with salt substitute (75% NaCl, 25% KCl) on hard outcomes, including stroke. During the same period of time, major advances have been made in understanding how the body senses and tastes salt, and how these sensations drive intake. Additionally, new insights into the complex interactions between systems that control sodium and potassium excretion by the kidneys, and the brain have highlighted the existence of a potassium switch in the kidney distal nephron. This switch seems to contribute importantly to the blood pressure-lowering effects of potassium intake. In recognition of these evolving data, the United States Food and Drug Administration is moving to permit potassium-containing salt substitutes in food manufacturing. Given that previous attempts to reduce salt consumption have not been successful, this new approach has a chance of improving health and ending the 'Salt Wars'.
过量摄入盐会导致血压升高,但这一观察结果对人类健康的影响一直存在争议。多年来,人们也认识到钾的摄入可能会减轻盐对血压的影响,以及对中风等结果的影响。最近的大型随机干预试验为用盐替代物(75%氯化钠,25%氯化钾)代替盐(NaCl)对硬终点(包括中风)的益处提供了强有力的支持。在此期间,人们对身体如何感知和品尝盐以及这些感觉如何驱动盐的摄入有了更深入的了解。此外,对控制肾脏钠和钾排泄的系统之间复杂相互作用的新见解突出了肾脏远曲小管中钾开关的存在。这种开关似乎对钾摄入的降压作用有重要贡献。鉴于这些不断发展的数据,美国食品和药物管理局正在推动在食品制造中允许使用含钾的盐替代物。考虑到以前减少盐摄入量的尝试并未成功,这种新方法有可能改善健康状况并结束“盐战”。
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